


A Long Way to Tomorrow REVISED

by The_Meridian_Complex



Category: Star Trek, Star Trek: Alternate Original Series (Movies)
Genre: Angst, Depression, Earth, Family, Hurt James T. Kirk, Hurt/Comfort, Injury Recovery, Medical Jargon, Medical Procedures, Medical Trauma, Pain, Post-Star Trek: Into Darkness, Post-Traumatic Stress Disorder - PTSD, Protectiveness, Radiation Sickness, Starfleet
Language: English
Status: Completed
Published: 2019-11-25
Updated: 2020-10-13
Packaged: 2021-02-25 22:47:27
Rating: Teen And Up Audiences
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 19
Words: 41,543
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/21563215
Author URL: https://archiveofourown.org/users/The_Meridian_Complex/pseuds/The_Meridian_Complex
Summary: Since awaking from his two week coma to find that seemingly everything in his life has changed, Kirk is forced to confront a new life completely dependant on others.Resisting treatment and fighting for some sense of control only impedes Kirk's recovery and convinces McCoy that under the scrutinizing eyes of Starfleet, he will kill himself for his pride.In a bid to save Kirk's life, McCoy takes him to Atlanta to heal surrounded by his McCoy's family. With many medical hurdles left to come, Kirk faces months of treatment and months of learning to surrender.The line is thin between surrendering to heal and surrendering to die.
Comments: 104
Kudos: 143





	1. Departure REVISED

**Author's Note:**

> THIS FIC IS IN THE PROCESS OF BEING REVISED. REVISED CHAPTERS WILL BE MARKED. 
> 
> I think that a lot of Star Trek post-ITD fics, and the movie itself, grossly underestimate Kirk's radiation injuries and his reaction to Khan's blood. This is an attempt to tell a more realistic, if somewhat darker, account of Kirk's recovery and the physical and mental toll it takes on Kirk and McCoy alike.
> 
> There are medical inaccuracies but I will try to keep them to a minimum. While I know that the Star Trek universe has advanced medical technology, I am still convinced that things like IVs are pretty much irreplaceable.
> 
> This is mostly from McCoy's perspective because he is the most intune with both Kirk and the outside world. Plus I love him.
> 
> This fic is also kind of a love story to semicolons, once you see them you can't ignore 'em. Someone please stop me!

**Summary for the Chapter:**

> After dying and being brought back to life, Captain James T. Kirk has a very long recovery ahead of him. In the hopes of making this difficult journey as easy as possible, McCoy makes the risky decision to move a still very fragile Kirk to Atlanta where both will be more comfortable.  
> As it is, Jim is barely ready to survive, let alone begin the long and painful trek back to his former self. McCoy hopes that in Atlanta, with family and love, Jim will be able to relax, rest, and heal.

**Notes for the Chapter:**

> Hello my loves!
> 
> Welcome to those of you who are reading this for the first time! I hope you enjoy! I always love to hear feedback and suggestions so don't hold back!  
> Welcome back to those who have been on this looong journey with me, I appreciate your support more than I can say.
> 
> I am currently in the process of revising this entire work for clarity, mistakes, and to recenter myself and figure out what I am really trying to say with this story. For those of you who read the original version, please let me know what you think about the changes and what I may be able to do better.
> 
> I love you all!

“Are you ready, Doctor?”

Spock stood in the doorway of Jim’s dimly lit room. The paperwork he was required to submit in Jim’s absence wasn't the only reason he had appeared at the hospital today, genuine anxiety was bubbling up at the thought of Jim’s departure. Spock, himself, could not do much at the moment but he had to see them off. 

He scanned the room, already ascertaining the answer to his question.

A hum of hurried activity filled Jim’s large, usually serene hospital room. The packing of equipment and preparation of Jim was almost enough to distract McCoy from Spock’s inquiry. McCoy’s world was very small now, his focus pinpointed on Jim day in and out. Only a tiny part of his consciousness bothered to listen to Spock, only a small part of him could dredge up the sarcastically drawled answer, 

“Of course I am, Spock. Don’t you worry your pointy ears.”

Spock didn’t react but it still amused McCoy enough to seem worth dragging some attention away from Jim and towards the alien lurking in  _ his  _ hospital.

Allowing the doctor to return to his contented fuming, Spock passively observed the bustling scene before him. It was going to be dangerous to transport Jim in his fragile condition, there was no preparation in the world that could ensure the captain's stability through the journey. It had, however, been generally agreed upon, if somewhat dubiously by some, that the months of rehabilitation Jim must endure would be better spent away from StarFleet and the scrutinizing eyes of its admiralty. With all eyes on the Enterprise captain in the aftermath of its disastrous crash, McCoy worried that Jim’s self consciousness and pride would hold him back during a recovery no doubt filled with failure, embarrassment, and the requirement to surrender his control and allow others to come near. Jim was always one to attempt a brave face, to ignore his own pain, to brush off any trauma, even to dire personal consequence. It would be better for Jim, safer and more relaxed, if they could get him away. McCoy hoped that without StarFleet, and the general public, breathing down his neck Jim could heal without being rushed back into a world he was not prepared to face. He had come back from the dead, but he was not truly in the land of the living, not yet.

Atlanta Georgia, McCoy’s home with a hospital he knew and trusted, a great deal more than StarFleet General, in fact, seemed like the ideal location for Jim’s recovery. Being so close to McCoy’s Momma’s home, he had promised Jim that once he was ready McCoy would take him to her house to finish his recovery someplace a little more comfortable. 

Jim hated hospitals more than anything and loved Mrs. McCoy like a mother. She, of course, cared for him deeply in return, seeing the connection the man had with her guarded, and often angry son. She had been more than happy to welcome them into her home, though McCoy had warned her gravely of Jim’s precarious condition and how it would likely be months before they would discharge him from the hospital. Mrs. McCoy acknowledged her son’s plan equally as solemnly, but secretly she was happy at the prospect of having her son home for an extended period. She had been overcome by worry for much of his time aboard the Enterprise, and had watched his daughter grow up without a father for long enough. It was time for him to come home, and she would do anything needed to ease the stress and despair in her son’s voice and help the poor child he had evidently exhausted himself saving. She may not know the half of Jim’s injuries but years as a nurse, maybe more so, decades as a mother, prepared her to face whatever was to come, calmly and with love. There was nothing that could stop her from helping her son, and the brother that he had chosen.

* * *

Since waking up from the two week coma following his temporary death, Jim had fought every procedure that would make him feel, or appear, weak: refusing pain medication, sedation, even supplemental oxygen; only surrendering to McCoy’s personal care, often under duress or once his condition became critical, and intervention unavoidable. His complete denial of the seriousness of his condition shocked everyone other than McCoy. From the moment he woke up Jim had tried to insist he was fine. 

_ Fine, but going in and out of consciousness, eh?  _

_ Fine, but unable to eat, drink, or sit up? _

_ Fine, but giving me a fucking heart attack every goddamn time your blood pressure and tempreture drop? _

_ Fucking fine, are ya? _

McCoy sometimes said these things and sometimes thought them, it didn’t make much of a difference. Jim was not just injured in body, his soul was damaged too, the very essence of all he knew was being dismantled as he discovered he had lost all control of his body, and was, infact, not fine. He was fighting his body as much as he fought everyone who tried to help him.

Jim’s stubborn wish to prove himself and a deep distrust of medicine had nearly brought his recovery to an abrupt halt more than once. Try as McCoy might, he could not always be by the captain’s side and Jim’s constant need for monitoring, regeneration stimulants, and physical therapy meant that sometimes he must endure the poking and prodding alone, from people he did not trust. Keeping him calm through any procedure required careful planning from McCoy at best, and restraints and sedatives at worst. Too many times they had run out of options, resorting to rushed methods that McCoy feared would create more trauma for the kid, despite their best intentions. McCoy could not imagine the psychological stress it was putting on him, adding to his damage every day. 

He knew Jim felt completely out of control, it was evident from his nightmares. Even under light sedation, the events resulting from the Tarsus IV tragedy were haunting him to no end, choking him and causing panic attacks, shaking, and tachycardia, sending McCoy over the edge along with him more than once. Jim had even begun to fight the sedation at times to avoid his dreams and the hands of strangers; only with the promise that McCoy would stand vigil, was Jim able to rest peacefully. Even with McCoy by his side, the cracks were beginning to show. Atlanta and escape really were the only remaining options.

Unfortunately, this time Jim really had no say in his sedation, an all too common trend for him. During the journey McCoy decided that, for his own comfort, Jim would be sedated and intubated to minimize distress and skeletomuscular injury and insure his lungs would stay uncompromised while moving him. McCoy wasn’t sure he would be able to take any more stress than the journey would already put on him, as much as Jim may not like it, McCoy’s visceral need to protect him took forefront in these uncertain times.

Spock watched carefully as the sedatives were administered through the small tube threading through the blankets near Jim’s groin.

After Jim had ripped out numerous IVs, usually because of nightmares and conscious panic attacks where he often became convinced that the medical team was there to harm him, the standard IV had become unviable as even approaching to use it would trigger Jim. A traditional long term port in his chest was also deemed too risky for the same reason; they could not trust anything that Jim could easily pull out. After some debate and a final fiasco involving a blood transfusion and a very nasty mess, Jim had a central line inserted into the femoral artery in his groin and threaded up near his heart in order to administer some of the stronger of his treatments as well as aid his weakened heart in the distribution of his normal meds. Jim had argued and fought the decision insisting that he wouldn’t do it anymore, that he didn’t even need an IV, that he would let McCoy use hypo sprays on him if he didn’t have to get a line, in the groin no less. Fed up with his repeated antics, McCoy, not so gently, explained that hypo sprays just wouldn't cover it when it came to running fluids every day to keep his blood pressure stable, and the administration of medication around the clock. To add to all the other treatments it had become apparent that Jim’s stomach would reject all food, even formulas nasogastrically, so intravenous dietary supplements would be added to the roster confirming that McCoy had made the right decision; he just wished that Jim hadn’t fought it so hard.

As the syringe plunger was depressed, Jim lay there motionless, eyes still open, scared and wide. Quiet for the moment, paralized by his fear, he struggled against the sedatives he knew were coming. Seeing Jim on the verge of breaking down McCoy rushed from his other activities to Jim’s side, cursing the poor nurse who had administered the drugs.

“Dammit, Gomez! I told you not to administer the meds except under my direct supervision!”

The nurse bowed his head, looking more than a little nervous as he replied,

“Sorry, Doctor! Doctor Ali ordered me to do it now as you are almost ready to leave!”

“Jack!”

“Come on, Len, leave the kid alone, we gotta get moving.”

Dr. Ali stuffed yet more of the specialized equipment quickly into bags. Only giving a small amount of attention to this particular McCoy meltdown.

Jim was still fighting the medication, McCoy still at his bedside trying to calm him and reassure Jim that he was there and watching. Stroking his sweat drenched hair he whispered,

“It’s ok, Jimmy, time to let go now. Don’t you worry, I’m gonna be right beside you the whole time. We’ll be in Atlanta before you know it. Don’t fight the drugs, kiddo. Shhh”

Finally, _ thankfully _ , Kirk surrendered to the medications and drifted off.

Spock noted from afar how thin Jim was becoming, his ribs visible even under the shirt, his hands white-gray and skeletal atop the blankets. His hair too, had become thin and splintered like hay and his lips, cheeks, and hands were dry and chapped. It all added to his ashy and darkly stained skin making him look eerily dead, nothing like his youthfully vibrant self. He looked so tired. Even sedated, his face had taken on a permanent pained expression. No amount of painkillers could wash away the hurt of every irradiated cell and each burn that Khan’s blood had caused from the inside out. 

To a certain extent there was not much they could do for Jim while Khan’s blood was still necessary. It was a vital part of saving his life but it caused him a nearly equal amount of pain, pain that they all had to witness but could not help.

Though he had left Jim’s bedside and was now rushing around barking orders once more, the Doctor didn’t look much better than Kirk. He too, looked pained, pale, and dead tired. If Spock was being candid, it was one of the reasons he had supported Jim’s transfer to Atlanta; infact, Spock was likely the deciding voice in the thoroughly split commit. The facts were undeniable, both doctor and patient needed the rest. It did concern Spock to have the captain so far away from StarFleet’s watchful eye, but the first priority must be Jim’s health, whatever was left.

Jim’s preparations were not over yet. Braces were being gently placed around Jim’s neck and joints to avoid their damage during transportation. The radiation had done a number on his connective tissue and bones and the mass immune response following the “super blood” transfusions had left them even worse. Dr. Ali skillfully intubated the captain with one fluid motion, a nurse starting yet another machine to add to the symphony around Kirk. Bundled up in a biobed transport covered in monitors and machines, Jim looked very small compared to the massive array of machinery that was keeping him alive. He was so very fragile, it took every last bit of their remaining hope to remember that he was one hell of a fighter.

Spock had seen enough, this was a sendoff he had not looked forward to. He bid the Doctor a short farewell that he assumed fell on all too preoccupied ears and made his way out. StarFleet would be expecting a discharge report on Jim imminently and a day hadn’t gone by without some sort of memo, call, or meeting that expected Spock’s attention. StarFleet could not know the true account of how Jim was injured or the events on the Enterprise that day and it was up to Spock to ensure that and to protect the other bridge crew members as they were the only others who had witnessed it all play out. Always cool and collected, Spock had thought himself more than prepared for the never ending interrogations, however, now even he was beginning to feel the strain. At least he could spare Jim from it, for now. 

Everyone stood clear as Kirk’s transport biobed was pushed out of the room. It was a somber farewell from the staff that had grown fond of the captain over the last month. With his outlook not altogether hopeful, they had to hold the possibility that this was a forever goodbye. With only McCoy, Ali, and the transport techs leaving with him, the rest trailed behind, carrying equipment to the transport craft. A senior nurse boarded to help lock Jim’s bed in place, reposition the IV and monitors and request the last signature from Dr. Ali. Then, with only the quiet sounds of the hovercraft, they were gone.


	2. Transport

**Summary for the Chapter:**

> The team flies towards Atlanta, McCoy is angry, and Jim bleeds.

**Notes for the Chapter:**

> Thank you all so much for the positive response! I've never had so many comments! I love it!
> 
> If anyone is interested in proofreading for me please reach out, I am definitely in need of someone to bounce ideas off and subject to my terrible writing.
> 
> Note on Biobeds:  
> I am basing this type of biobed off the ones from TOS and the movies. These were mostly meant for surgery but served other purposes. They had an arch that went around the patient's waste, it contained the instruments to operate with plus sensors. I think this makes much more sense.  
> For reference https://memory-alpha.fandom.com/wiki/Biobed

McCoy felt sick. Sick and tired. Not only was a hover transport his least favorite way to travel, having to sedated Jim had become a terrifying ritual; there was no guarantee that he would come out if sedation but the stress from being awake could be just as bad. Yet another gamble on Jim's life he was forced to make. The images of Jim fighting the drugs always haunted McCoy. He wished the poor kid could just trust him and rest. He wanted so badly to take his pain away.

McCoy cradled Jim’s boney hand gently in his strong ones, giving himself comfort more than anything. His head bowed in exhaustion, drooping towards the captain’s bed. It had been his resting place for more or less the last month. McCoy could only sleep when he was near enough to hear Jim’s forced breathes and ragged heartbeat himself.

Ali didn’t disturb the doctor as he continued to monitor Kirk and start the transportation report. As one of McCoy's few close Starfleet friends he had agreed to come as an assistant and overseer of the operations in Atlanta. Starfleet tasked him with keeping an eye on McCoy, making sure he was still fit for duty and that Jim was properly cared for in these unusual circumstances. Ali, however, did not share Starfleet’s concern. McCoy was doubtless their best medical officer and Jim would not recover in anyone else’s hands.

It was only days ago that Ali could even touch Jim while awake without incident. The kid fought everyone he was not intimately acquainted with. Nurse Chapel had to be brought in from shore leave as the only nurse able to bathe and dress him. Mostly McCoy took care of it all. Every procedure, no matter how minor, could only be accomplished by McCoy without a passionate fight. He had the most incredible effect on the young captain. McCoy’s usual, rough, teasing, and frequently grumpy bedside manner, often directed at Kirk, had slowly given away to gentle touches, low whispers of praise, and an ever present hand to hold. Jim did not seem the verbally emotional type. The only admissions of pain or fear Ali had witnessed generally came in the form of sharp stifled cries during the deep muscle injections and angry protests at anything else administered by a stranger. 

Only in recent days, as McCoy prepared him for their departure, did Ali come to understand a bit of the true level of pain Kirk was enduring. It was just barely visible in the clenched fists, the closed eyes, and the tears of pain, exhaustion, and defeat seeping slowly when he thought no one was nearby. Ali did not understand the fear, but he now saw it plain as day, and the necessity of McCoy's comfort.

There was something special about the two men; Ali had worked with McCoy enough to know that his bedside manner, especially with Jim, was usually a quip and a pat on the shoulder at best. He wasn’t exactly what you would call tender. But on occasions when children had been brought in to the trauma center, he had witnessed McCoy change. Nobody dare mention it, but around children McCoy softened a bit, his southern drawl was ever a bit more pronounced, a few more “Darlin’s” added in.The way McCoy treated Kirk, like an old friend, like a child; and the way, in turn, Kirk went from frightened and fighting to compliant with the doctor alone. It was something to see, but something to witness quietly and from afar. Ali had watched enough sickness and pain both on Earth and off it to know that medicine alone is not enough to heal someone. A person must want to heal and it seemed to Ali that the only person to make Kirk want to live was McCoy. It was a power beyond friendship but McCoy wielded it so gracefully.

Not to mistake it, the fear the McCoy had lived with during Kirk's coma had been intense. Ali had often wondered if a breakdown was imminent. There were many nights Ali had sat with McCoy by Kirk's bedside and let the other man cry silently in the darkness. He had been so so scared of losing Kirk; and when the captain finally awoke the tension building in the doctor only mounted. The kid was so reluctant to be treated. Ali could see how it broke McCoy's heart, and now watching him sleep on Kirk's bed he prayed that this would be a changing point, this could bring both men back from the brink. 

Ali had watched, fascinated, over the weeks of Kirk’s stay. He watched how McCoy had refused to step away from Kirk while he was still comatose. It was like McCoy knew that he absolutely had to be there when Kirk finally awoke, had to, or Kirk may fall apart.

When the day finally came, all the fear and pain Ali witnessed in McCoy was neatly buttoned away. Somehow, McCoy was able to hold it together, to lighten the mood and quip with the gravely injured captain. It had, quite frankly, bewildered the other doctor. It did seem, however, to have served its purpose. Kirk awoke, and while in pain and disoriented, he had seen McCoy, and McCoy had acted as if everything was ok, and Kirk believed him. Ali had seen Kirk angry, violent, untrusting, and afraid so often in these last weeks, but with McCoy, Kirk could be calm. It was about trust. It was about McCoy’s steady hand on Kirks shaking one, his hand through that brittle hair. It was a type of intimacy only friendship could bring on. Its how Ali knew that Kirk could only recover with McCoy by his side, and that anyone else near them must be extremely careful. Kirk’s trust was not easy to win, and desperately needed to save his life.

Ali also knew that it wasn’t only Kirk who was in for a rough recovery. This had not been easy for McCoy, and there was only more suffering to witness from here.

McCoy woke with a start, raising his head off Jim’s biobed and rubbing the fatigue from his eyes.

“Jack, come on! What did I tell you about letting me sleep!”

“Len, calm down.

“Let’s be real, you needed it”

McCoy cursed under his breath and glowered at his friend

“Jack I swear to god…” Running his hand through his unwashed hair and pulling himself shakily from the bench of the transport vehicle.

“I’m not your damn patient, I’m in charge here and you are one shit assistant!”

The transport bumped and shuttered causing McCoy to sit back down heavily 

“Look _doctor”_ Ali said pointedly

“I’m here to watch out for the both of you and you can’t fucking focus unless you get some sleep, now stop being a fool and help me run some more fluids”

Guiltily McCoy looked down at the man he had momentarily forgotten about.

He froze instantly.

Blood was running steadily out Jim’s nose, down his cheek, forming a small puddle near his right ear.

“Fuck.” Ali took one look at Kirk and one at the monitors above the biobed before the blood pressure and O2 alarms started to sing.

McCoy didn’t waste any time, practiced in the art of trauma surgery, his movements were fluid as the biobed’s arch was activated, extending around Jim’s middle and beginning the constant pre-surgery analysis protocols. These weren’t strictly necessary now, but any additional blood loss could result in terrible damage. 

Putting his hands under the ion sterilizer at the side of the bioarch and putting on gloves, McCoy prepared himself; meanwhile, Ali put down sterile dressing and began running more fluids and upping the oxygen through the respiratory tube. Using the visual guidance probes, a set of forceps, and the laser cauterizer taken from their sterile compartments in the bioarch McCoy steadily threaded the probe and cauterizer through Jim’s nostrils and into the sinuses to attempt to find the bleed. Jim was already choking slightly on the blood running down his throat, even through the sedation. Any of the most minor things could kill the kid. 

The cauterization was fairly quick, the blood stopping almost immediately; restarting however, with a constant string of new bleeds, some now nearing his throat. Blood was already starting to seep from Jim’s white lips before McCoy could stop the bleeds for good.

Pulling off the gloves, he dabbed half heartedly at Jim’s blood on his shirt. This happened all too often. Jim would kill McCoy young. Well not young… but younger.

It was a chilling reminder of how fragile Jim still was. Even in the pressurized cabin of the transport, even with the liquids and medication flooding his bloodstream, even with McCoy, Jim was just seconds from falling apart. Sure, Khan’s blood was incredible in its “resurrection” capabilities, but as it healed one cell -Jim’s body fighting it all the way- the radiation was damaging five. It was a never ending uphill battle for Jim’s life. 

McCoy felt so guilty; he should’ve paid more attention to the captain than his colleague, more importantly, he should have been awake!

His hands had been steady as stone while operating, but now that the alarms had silenced and only the sound of Jim’s heart and respiration remained, did McCoy’s hands begin to shake. He couldn’t handle this constant stream of stress much longer, he was getting too damn old for this.

The sound of the pilot alerting them of an imminent landing broke McCoy out of his shock. He did not look at his colleague -perhaps out of frustration, more likely out of shame- as he quickly packed and prepared to move Jim once more. There was no time to waste, and hopefully, no time to think.

**Notes for the Chapter:**

> I am considering another part to this story, turning it into a series; this part would solely discuss Star Trek medical equipment as it exists in my version of the universe. It would be more like a reference book instead of a story and would feature descriptions and drawings of the equipment.


	3. Arrival

**Summary for the Chapter:**

> The transport touches down and, for the first time, McCoy allows others to look after Jim while he meets with an old friend.

**Notes for the Chapter:**

> Sorry I haven't updated lately! As most of you probably know, this was Thanksgiving so most Americans have been getting tortured by their families for the last week.  
> I've been writing this in spare moments at my inlaw's so I apologize for it being short and not fantastically edited.  
> I was going to make this part of a bigger chapter but I figured if I could update more frequently that would probably be better.
> 
> Question: would you prefer more chapters or longer ones?

McCoy’s muscles tensed as the transport door opened with a whirr, letting in the bright afternoon sun and a wave of sweltering air, threatening to choke him. Ah home sweet home. The familiar smell of heat and humidity calmed McCoy, but only for an instant.

“It’s time to rock and roll, Len”

The receiving teams sudden influx into the small transport was overwhelming and filled McCoy with a wave of anxiety; another symptom of Jim being sick all this time, not only was Jim reluctant to allow others to touch him, McCoy cringed inside any time someone else tried to intervene without his direct instruction.  
People were surrounding Jim, moving equipment and securing a covering over the biobed to shield him from the sun and heat. Ali was calmly talking to the head nurse and giving instructions and updates on the last small crisis. McCoy was frozen in the doorway until he heard the voice,

“Well I’ll be damned, Leonard McCoy finally returning home! Starfleet’s golden boy, huh?”

Dr. Thomas Carter was tall, lean, and blond as a baby. His friendly southern drawl rang out as he laughed and walked towards McCoy with open arms.

“Good to be home, Tom. I’m glad you didn’t burn down the place in my absence.”

Carter in turn gave a joking pout and motioned for him to disembark from the transport. McCoy hesitated looking back towards Jim, swarmed with people.

“Come along Len, my team and your man will take good care of him. Let me take you to ICU, we’ll meet them there.”

McCoy could not turn down the obvious instruction and decided to surrender to his friend’s judgement just this once. It didn’t seem like he could do much anyway, as soon as he stepped off the transport Jim’s biobed was taken out and quickly brought in through the emergency entrance, presumably headed to his room already.

“So, medical director of the Intensive Care Unit? That sure is a step up from our ER days.” McCoy chuckled, following Carter through the staff entrance and receiving a badge.

“Chief of Medicine, actually.” Carter smiled proudly surveying his hospital.

“No shit? You told me you would be assisting with Jim’s transition?"

“I’ve made time, your Captain is a top priority. I’ve received several strongly worded messages from a certain Officer Spock requesting special accommodations on behalf of Starfleet, one doesn’t ignore those types of messages.”

McCoy smiled to himself, maybe the green-blooded bastard wasn’t so bad afterall. He wasn’t looking forward to informing him of the nose bleed though.

“Well, thank you Jack, truely.” Despite his best efforts the joking tone had left McCoy’s voice.

“Don’t Len, we take care of our own here.” Carter scanned his badge and opened the heavy ICU doors,

“After you.”

It was nearly as McCoy remembered it in his trauma surgery days. The lights were bright and the monitoring stations were all a flurry of activity, always a nurse with a flashing datapad dashing in and out of rooms.  
The nurses station right in the middle of it all was still run by Kirsten Nightly, older than he remembered, but still the calm, matron of the most hectic place in Atlanta.

“Well well well, Leonard, truly a sight for sore eyes.” Her smile was genuine even if her eyes were tired.

“Your patient is getting settled in now so don’t you worry.”

Carter must have warned her of his fragile attachment to Jim.

“Let’s get a look at you, baby” she held his unshaven cheeks between her small hands,

“You look more tired than a peach in January”

“Well some flatterer you are, Kirsten” McCoy rolled his eyes and chuckled.

“Now, as much as I’d like to shoot the shit with you fine people all day, there is work to be done.” His eyes scanned the distantly familiar ward, searching anxiously for Jim.

“Your boys right back here, sugar.” Nightly led the doctors to the farthest room, somewhat isolated behind opaque glass.

Jim had been transferred to a long term biobed, the bloodied shirt removed, and his face had been wiped clean. Still under sedation, he looked peaceful as the arrival team left, handing Ali their final sign off report. 

“Tom, this is my right hand man, Dr. Ali,” Ali looked up from his paperwork to shake Carter’s hand.

“Jack, Dr. Carter and I worked in the ER and Trauma back in the old days.” 

“Nice to meet you Dr. Carter. Now, tell me, was Len always such a curmudgeon?”

“From the day of his birth, if you ask me.” The men laughed as McCoy scowled and cursed for theatrical effect. 

It was, perhaps the first time genuine laughter had been heard in Jim’s hospital room. It faded, almost too quickly, when the attention was turned once more to the sedated man.

“So, this is the Captain?” Carter turned inquisitively to McCoy,

“Is he even allowed to drive a car yet? He looks like a teenager!”

This time McCoy didn’t smile at the joke. It was true, after losing over 20 pounds in the last month the kid looked like a small, starved child.

“Yeah… This is Starfleet Captain James Kirk. Not too impressive but the poor kid has been through hell and back”

Hah, that was all too true. The classified manor in which Jim had died and been resurrected made it more than a little difficult to secure medical help. Only Dr. Ali, the bridge crew, and McCoy knew the most intimate details of Jim’s situation, everyone else was in a sort of twilight of truth.

“Len, are you ready to wake him up?” Ali put a firm, but comforting hand on McCoy’s shoulder.

McCoy closed his eyes and took a deep breath

“Let's do this.”

**Notes for the Chapter:**

> Thanks for reading guys!  
> I love you all! The support has been really inspired and I'm so thankful!


	4. Waking Up is Hell for the Weary

**Summary for the Chapter:**

> McCoy and Ali are finally able to wake Jim up, but when is anything easy with Jim?

**Notes for the Chapter:**

> Thank you all so much my loves! As always, the support has been wonderful!
> 
> Finally a chapter with Jim (somewhat) awake. I know it's taken forever to get here but I think that from this point things will move more quickly. Hopefully it's been enjoyable so far.
> 
> This is when the medical stuff starts to amp up, I am not a medical professional, just a med nerd, so please correct me if I got anything wrong. Additionally, let me know if any of the acronyms I use now or in the future are confusing.

Dr. Ali slowly pushed the first syringe of medication to wake Jim up, one of three in the protocol to see how well the Captain could come back.

_ Sissss _ the first hypo released a muscle relaxant to keep him from seizing, placing it on the table and grabbing the next one, McCoy gently cradled Jim’s head, pushing his now long, shaggy hair away from his neck and administering the last hypo.

It should be about five minutes before the sedation induced paralysis wore off and the intubation could be replaced by an oxygen mask. 

McCoys eyes were firmly set on Jim, his ear on the machines monitoring him.

“Something's off!”

The medication was working too fast, alarms crying out.

Despite the muscle relaxants, Jim seemed to be seizing, his eyes opened, terrified and wild, choking on the tube still down his throat. Tears poured down his face and bile dribbled out the corners of his mouth, around the tube. 

McCoy’s well trained reflexes jumped into action before his brain could, he had never removed an endotracheal tube so fast in his life.

Jim was coughing and retching, unable to speak, only to vomit the contents of his empty stomach: bile and mucus mixed with blood from his raw throat. 

The Emergency Response Team rushed in, handing McCoy and Carter hypos. Each standing beside Jim, nurses holding him down, they administered another relaxant and additional pain medication. 

Gradually, Jim could breathe raggedly and panicked, but thank God, on his own, O2 alarms rang out urgently, his mouth wiped and a mask put in place. Shifting him upright, McCoy comfortingly rubbed his back, attempting to subtly hold him in place as his panic began to mount again. 

Jim had finally noticed the ERT, strange doctor and nurses, and his unfamiliar surroundings. Jim felt like he was dying, but at least McCoy was there. Even he could barely stem the panic. 

Feeling the mask, biomonitor, and Bones, holding him, pressing into him, sent Jim into fight or flight once again, he thrashed, trying to pull away from everything and everyone. The whiplash of his sudden movement sent another wave of nausea through him, the vomit choked him again but the thrashing persisted. 

The ERT nurses rushed forward to help restrain Kirk, only worsening his panic attack.

“For Christ’s sake, keep away from him!” McCoy was holding on to the kid for dearlife, still trying to calm him, stroking his back as he held Jim in place.

“Get the hell away, you’re all making this worse!” McCoy couldn’t control himself, he just needed everyone gone so Jim would calm the fuck down.

“I think it's best we leave, team.” Carter herded the rest of the doctors and nurses out of the room, leaving only Ali and McCoy behind.

Slowly, the thrashing and fighting was reduced to coughing and shaking. Tears still streaming down his face, mixing with the sweat.

“I’ve got you Jimmy, everyone is gone, its safe darlin’.”

Jim took a ragged breath and flopped back into McCoy’s arms, utterly exhausted.

McCoy could only imagine the strain and damage that must have caused his weak lungs, atrophied muscles, and irradiated bones, it may set them back days or weeks. 

He cursed silently,  _ this was WHY we sedated him in the first place. _

The new set of relaxants and pain meds seemed to finally be working, Jim was getting groggy, letting McCoy wipe the bile, snot, and tears from his face, tenderly placing the oxygen mask back on, stroking his hair.

“You’re ok now, kiddo. I’m so so sorry. I promise I’ll be here when you wake up, get some sleep, everything will be ok.”

_ Thank God he still believes me, his trust in me is the last damn thing keeping him from death’s door and things are still going wrong. _

Jim finally fell asleep, McCoy wiped the sweat from his own brow, looking up at Ali who was carefully studying the monitor above Jim’s bed.

“His BP is dropping, I better run some more fluids, he’s throwing up all the fucking electrolytes and potassium he has left.”

McCoy nodded his agreement before looking back at the sleeping kid.

“What the fuck just happened…?” Rubbing his tired eyes and trying to even out his own breathing.

“Are you sure you gave him the right dose, Jack?”

“Pretty damn sure.” Ali replied, shaking his head,

“You know how unpredictable he can be these days. Khan’s blood has altered all our calculations in ways we can’t even pretend to predict.” 

“Look at his blood levels for instance” gesturing at the biodisplay

“We’ve been pumping glucose into him all day, and his blood sugar still won't stabilize.”

“It must be the infusions that keep messing with his metabolism. We can’t stop them, whatever of Khan’s blood is left we have to keep giving it to him until we can get the radiation cell damage under control, maybe we can dilute it more?”

“I think it’s the only way, if he loses any more weight, he’s fucked. I’m not even sure he can keep down an NG tube at this point...”

“We can’t try just yet, Jack. Let’s give the kid some time, he’s been through more than enough for now.” McCoy looked down at his sleeping patient, he had remained calm for him through the day but now he felt completely exhausted, on the verge of breaking down already.

“You look like absolute shit Len, I’m gonna go find us something to eat, you take a seat before you pass out.”

Falling heavily into the chair next to Jim, McCoy felt defeated and empty. Today had been bad, worse than they had expected, already the lowest of bars.

Only resting for a second, McCoy signed and conceded to the fact he had to call Spock before the commander mysteriously found out some other way.

The pad barely acknowledged the call before Spock’s face appeared on the screen,

“I trust you have landed and have an update, Doctor?”

“Hello to you too,  _ Commander _ ,” McCoy simply wasn’t in the mood to talk to a Vulcan

“I do have news, but your not going to like it.”

Spock’s expression changed subtly into concer n.

“Please proceed, Doctor.”

“While in transport Jim got a severe nosebleed, I had to cauterize it before he lost too much blood. His tissue it just so damaged…”

Spock didn’t respond, his expression unchanged.

“Once we arrived we attempted to wake him up, but something went wrong. The medications worked too quickly. He woke up before we could take the tube out of his throat. He was coughing and vomiting all over the place, Spock, he was fighting with everything he had.”

This time Spock’s expression did change, genuine concern, maybe? McCoy was too tired to guess.

“His metabolism is all fucked up,” Spock’s lips pursed in disapproval at the unprofessional language, the fucking bastard.

“We can’t seem to stabilize his blood sugar and with all the vomiting he’s losing vitamins and minerals left and right.”

“What’s the prognosis, Doctor?”

“Well it sure as hell ain't ideal, I think we can stabilize him again, but he’s not doing so well Spock…”

“Shall I come to Atlanta?”

“Not just yet, let's see how he does for a bit. Hopefully we can turn this thing around.”

“Very well, Doctor. And you are caring for yourself?”

McCoy laughed tiredly

“Back off Spock, don’t you have real work to do?”

Spock shook his head but didn’t press the subject.

“I should go, we’ve got a lot to do before Jim wakes up again.”

“You will call me with any changes in the Captain’s status?”

“Of course.” McCoy was so damn tired.

“Goodbye Spock.”

The Commander nodded and disappeared from the screen.

McCoy leaned back and closed his eyes. He wasn’t sure he could keep doing this. Jim kept almost slipping out of his hands time and time again, when would the day come where he couldn’t hold on anymore? He couldn't lose Jim.

Sitting up to his pad allerting him of another incoming call, he tried to straighten himself out. It was Elanora; shit, he’d forgotten to call her when they landed.

“Hi momma” God, he sounded like shit.

“Len… How’s it going baby? You didn’t call and I was getting worried.”

“I’m sorry, momma, it just seemed like one crisis after another, things aren’t going so-” There, finally his voice wobbled, only for a second, threatening the break down the floodgates, taking the last bits of McCoys strength with them.

“Oh baby, I’m so sorry. Jim hasn't handled the travel well? Poor doll.”

“I’m - I’m so scared momma, I always feel like the next time will be the time he does something unfixable.” He almost choked trying to swallow down the lump in his throat. 

“I’ve just almost lost him so many times now, I just don’t know how to keep going… I just don’t know how to help him…”

“Honey, you are helping him. You’re the best damn doctor he could have and on top of it you are his friend and he trusts you. He is trusting you with helping him so the least you can do is trust yourself.”

“You’re right… I’m the only one he trusts… I’m the only one who he’ll let help him.”

“Well then, I'm sure you’re going to do a mighty fine job, that's the boy I raised after all.”

McCoy the younger smiled at that. It was true, momma was always right.

“Thanks momma”

“Of course, baby. Now, you sound bone-tired, get some rest honey, let me know when we can come visit. Jojo and I are dying to see you.”

That made McCoy’s heart ache even more. How he longed to see his baby again, he hated putting work in front of family, but it was part of the job, and Jim was his family too.

“Will do. Good night momma”

“Good night Len, you take care of yourself, ya hear.”

McCoy turned off the pad and closed his eyes, he only meant to rest them, but he was asleep before he could put the pad down. Might as well, a calm moment with Jim was rare these days, actually, it had always been rare.

Ali returned, smiled at the two men asleep, and left. Any shut-eye a doctor could get was precious.


	5. Pain is a Constant Companion

**Summary for the Chapter:**

> McCoy and Jim, sometimes asleep, sometimes not. Regardless, every moment is a struggle against Jim's body.

**Notes for the Chapter:**

> Sorry this has taken a while guys!  
> This chapter has been a real bitch to write, especially with a lot stuff going on at work and home. I will try to update more frequently in the future. I have planned out quite a bit of the story line but its really difficult to keep each chapter on track when there are so many details I want to include.   
> It's a long chapter and I am not quite sure how I feel about the flow of it since I wrote it in so many pieces. Let me know what you guys think, I love me some constructive criticism! 
> 
> As always, love you all!  
> Hope you enjoy!

When Jim awoke again the room was silent, his surroundings only visible through the weak light of the biobed’s readout above his head.  
He could just make out Bones in the chair beside him, head bent and lightly snoring, he looked as pained and exhausted as Jim felt; Jim didn’t have the heart to wake his doctor, his friend.

Jim looked up at the ceiling, trying desperately to adjust to the new surroundings. He could only lay there in the relative dark and silence for a few moments. The pain medication wearing off must have been the thing that woke him because suddenly it was washing over him, an overwhelming wall of paralyzing pain. He tried to keep quiet, not wake Bones, definitely not cause a scene in this foreign place. Setting his jaw, squeezing his eyes shut, and trying to breathe evenly or at all, were the only things he could manage and even they were slipping away from him at an alarming rate.

It wasn’t long until biomonitor chirped urgently, alerting anyone that could hear of Kirk’s distress; pain monitors had made leaps and bounds but with Jim’s uncanny pain tolerance and force of will he was able to evade them- to a point. Once the monitor could register Jim’s pain levels as worryingly high, he was usually nearing the point of blacking out.

McCoy sat bolt upright, he knew that sound and what it meant for Jim. Cursing himself for falling asleep yet again on the job, he hoisted his tired body from the chair as quickly as he could, fear rising in his chest, displacing oxygen.

“Jimmy?” He barely expected a response. Jim’s eyes were screwed shut, his breath shallow and forced, he was obviously at the very end of his tolerance.

“Dammit kid, why didn’t you wake me when you woke up? You dumb, stubborn bastard, you could have avoided this all!”

Even before he could finish the sentence McCoy realized he couldn’t be mad, the monitors warned of dangerous respiration stats as Jim’s breath got more uneven.

The hypo full of pain killers was an immense relief to them both. Jim began to relax, tightened muscles slowly unknotting themselves allowing him to breathe shallowly, still, but evenly.

“I’m sorry kiddo,” McCoy gently holding Jim’s hand, still shaking from clenching too long.

“I should have been awake to give you more meds, I fucked up, but it won’t happen again.”

“S’okay Bones… I should’ve told you… s’not your… fault.” The drugs were pulling him under, this time he surrendered to them, relieved to be free of the pain.

“I am so so sorry darlin’” McCoy was furious, why didn’t anyone ever fucking wake him up? Didn’t they realize how serious this was? And himself how could he be so negligent? 

He stood by Jim’s bedside for several more minutes, watching him sleep, watching his vitals stabilize, treasuring the moment of peace, of Jim almost free of pain. The slow rise of the Georgia sun painted Jim in a lightly rarely seen in these dark days.

Pain management had been a nearly insurmountable obstacle since Jim had awoken from his coma. The list of pain medications he wasn’t allergic to was short at the best of times but the Khan transfusions had twisted his immune system in so many different ways that in the early days trying any medication was a risk. Even now, at any time, a medication they had used previously with no incident could cause acute anaphylaxis without warning.   
More medications were crossed off the list every week.  
Even without the risk of reaction, Jim’s irradiated liver was too fragile to handle much, and his kidneys were already showing signs of medication-induced damage.

Still, with the risks accounted for, Jim was in an incredible amount of pain and, for the time being, required a constant dose of pain medication inorder to function at all. He had tolerated a lower dose for a few hours of regeneration therapies but it wasn't long until it became apparent that Jim was struggling to breath and stay conscious for more than a short time. McCoy dreaded the day he became intolerant to the medications and the weaning process would begin. Like the kid needed anymore suffering.

The next time Jim came to the sun was beginning to fully light the room, softened by the opaque glass and white shades. He felt groggy and only half there, his body too heavy to move, even his eyelids felt like they were weighted down.  
Bones never missed anything though, provided he was awake, the subtle change in a heartbeat, the slight shift, and the accompanying barely audible sigh were clear as day to the doctor in his extra vigilant state.  
Jim always tried his best to be completely still and silent whenever awaking in a medical facility, too much trauma, too little trust, McCoy guessed he never really woke up without fear. Over the years McCoy learned to read Jim’s body before even trying to delve into his mind; the signs were subtle, but always there, a language only McCoy knew. 

“Hey morning glory” He raised the bed slightly, hoping that would help Jim feel more awake and human.

Now Jim fully opened his eyes, looking towards the voice, his body hurt, he didn’t want to tell Bones but, after last night, he though it might garner some good will with the doctor

Intending to speak, Jim opened his mouth only to gasp for air and let out a rasping cough.

“Jesus Jim… breath kid, in and out.” The real concern in Bones’ voice made Jim cringe on the inside but all he could do was breath and try not to cough again.

His throat was so so dry

“...water?” it was the only word he could get out before coughing again, the familiar taste of bile beginning to appear at the back of his mouth.

“Okay, but just a few sips, we don't want you throwing up anymore; it's done quite a number on you already”

Jim gave McCoy a tired, but questioning look, taking the straw McCoy offered into his mouth but still asking what had happened to him with those big, blue eyes.

“I don’t know if you remember Jim, but when you first woke up here you freaked out a bit, the endo-trech tube was still in ya and you did quite a bit of spewing your guts before we could sedate you.”

The embarrassed flush was creeping over Jim again, he didn’t want to know this, but he had to.

“All the vomiting means you’ve lost quite a lot of electrolytes and the bleeding in your throat is going to put a halt on us trying an NG tube again for a while.”

Jim frowned, he hated this, he hated the nasal-gastric tube of course too, but not as much as he hated not being able to eat, or really to drink, and getting skinnier by the day. He felt like he was disappearing little by little. His control over every bit of his body was long gone for sure.  
Still, even the little sips of water he was taking hurt; his throat ached terribly and the moment the water reached his stomach it would cramp and he would gag.  
Noticing the gagging, McCoy took the cup away again, Jim looked dismayed but relieved.

Somehow Jim managed to choke down the water coming back up from his rebellious stomach. Blood and bile were the only things he really got to taste these days, that and the unsettling taste of medications being pumped into his central line. Khan’s blood tasted like salty-sweet, metallic poison and lingered in his mouth for days after every infusion. 

Jim’s hand was clammy-cold as McCoy squeezed it, he had the decency, or rather the practice, not to mention the tears of frustration in the kid’s eyes. He knew this had to be hell for him, Jim was always too independant and now all that was gone; even his stomach was fighting against life.

The hand slowly went lax in McCoy’s grip, Jim already drifting off again. It was no surprise, in the last several weeks Jim hadn’t been able to stay conscious for more than a couple hours and after the drama of the last couple days, McCoy expected Jim would be sleeping for most of the week.  
It was probably for the best, the coming weeks would not be fun for him. Jim was progressing much slower hoped. Even though it had been agreed that after a few days at Atlanta General Jim would be moved to Mrs. McCoy’s home, it was likely he wouldn’t be cleared for discharge for several weeks. It was not going to be pretty telling him, but this certainly wasn't the time.  
Additionally, Jim had a whole new round of treatments ahead of him. In sleep time meant nothing to Jim and McCoy was going to preserve that gift as long as possible.

After a month of extensive physical damage, the psychological pain was now showing through. It was likely to be the greatest challenge; a body will not heal if the mind doesn’t want it to. Jim, always prone to perfectionism and quick frustration, would have to keep fighting through the setbacks and treatments whose benefit wasn’t immediately apparent. While pain would definitely contribute to the wearing down of Jim’s mental strength, it really wasn't the main concern; Jim had dealt with more pain in his short life than any man should tolerate. He came out the other side with an iron will, high mental walls, and the constant expectation that more pain was coming. It was the loss of Jim’s autonomy that McCoy feared would be the breaking of the man. 

The once completely independant captain could now barely hold a cup without tremors starting. His muscles had become weak, damaged from radiation, deoxygenation, and disuse. He could not sit u by himself, and with legs broken by trying to save the ship and the resulting slowed repair, it was unlikely he would walk for weeks. Every bodily function required some kind of medical assistance. His privacy, his control, even his fucking dignity had been stripped from him.   
McCoy felt guilty, sure, it wasn’t exactly his fault, these things were necessary to keep Jim alive, but it didn’t make it any easier to watch him change so drastically. McCoy’s professional detachment was impossible in this case. It had almost caused his removal from the care team more than once but it was also the reason Jim was still alive and fighting. Jim didn’t just need a doctor, he needed a friend.   
Where was the line though? McCoy sometimes felt that the question would be the defining one of his life. When it came to Jim that line was in almost constantly jeopardy, Jim needed care in more ways than one: Jim needed to be cared about, not just cared for. But at what point was McCoy caring too much? If he were to lose Jim, there was no doubt a part of him would be lost too.

Looking down at the sleeping man, pale and skinny, but with the same familiar lines and angles, a body so often broken and torn, McCoy knew too well; dammit, McCoy knew he would be there for the kid until the bitter end. Nothing could stop him. He loved the poor bastard, God help him.

**Notes for the Chapter:**

> A couple notes:
> 
> \- I don't know if this has been too subtle but the names of the characters change based on the dominant perspective. For instance, when the dominant perspective is Jim, McCoy becomes Bones but when the dominant perspective is McCoy it makes more sense for him to be referred to as McCoy because that's who he is to himself and everyone besides Jim. It's not all that consistent but I think it makes sense within the story. Is it confusing or unnoticeable?
> 
> \- This chapter does talk about how Jim is unable to eat or drink, I was going to include how he gets nutrients but it was just getting too long and rambling so essentially he is fed intravenously. I will explain more later but if you are curious now you can look up TPN.


	6. Reflection and Hunger

**Summary for the Chapter:**

> Jim's new health issues are dredging up his ancient trauma and McCoy won't leave his side. McCoy reflects on his friend's conditions and the numerous medical interventions that have been used to save his life, often at great risk.   
> While McCoy works day and night to save Jim's life, it is becoming too much for him to handle.

**Notes for the Chapter:**

> The holidays are crazy, right?!  
> I'm sorry it's taken quite a while for a relatively short chapter. I've been struggling to figure out where I'm going with this story but things are heating up! This is a bit of a departure from the plot to explain some of the medical details around Khan's blood and Jim's Tarsus IV trauma, but to be honest I freaking love this medical stuff!  
> I promise Mrs. McCoy will be in the next chapter.
> 
> Love you guys!

It had been agonizing to watch Jim comatose for weeks. As a surgeon, a man of action, the uncertainty that Jim would ever awake again had nearly driven McCoy insane, he prayed every day to see those blue eyes again, and sat vigil by his bedside anxious not to miss any sudden return to consciousness.  
With so many weeks of worry, McCoy hadn’t fully prepared himself for life after Jim woke up. Once Jim had finally awaken the stress and doubt did not lift, it only morphed into fears of losing him to unconsciousness again.   
Now, after weeks of Jim semi-awake and in pain, watching the man sleep peacefully was something of a relief.   
These were times McCoy was forced to reflect and plan and worry.

As exhausted as the doctor was, and Jim becoming more stable, McCoy should have been able to finally make the trek to his mommas house and get his first real night’s sleep in months; but just as soon as Jim had begun to stabilize in Atlanta, the nightmares began to start.

It was hard to see, hard to imagine, but Jim was slowly starving to death. It was not an unfamiliar feeling to Jim, hunger had been a constant companion on Tarsus IV. It brought out the child in him: tough, tight lipped, and scared. As he got skinnier the nightmares got worse, his hunger sparked the memories, rekindled the trauma he had managed to avoid. In his dreams he couldn’t escape the famine, the people he had lost, the horrors he had experience. The dehumanization he experienced never truly faded. Sedation made it all worse, made Tarsus IV deep water he was unable to surface, he begged McCoy not to sedate him anymore. McCoy only did it when he had no other choice. Regardless, McCoy was there to witness the nightmares, to hold Jim when he would allow, to try and wake him whenever possible. Jim had never had a comforting face to greet him as he awoke shaking, wet with practiced, silent tears. The hunger tearing him down was ancient, but the compassion was new.

Jim’s persistent weightloss had been a pressing issue since the beginning; even in the coma he wasn’t able to keep anything down; NG tubes would be thrown up immediately, even when the GJ tube was surgically inserted into his abdomen, most of the formula would be thrown up, and the small amount left was rarely absorbed. Jim lost over 30 lb in the first month, he looked like he was on the verge of starving to death. It was obvious that the formula alone wasn’t enough to keep Jim alive; the situation was becoming dire. Though McCoy had dreaded it, the last resort was to put Jim on a course of total parenteral nutrition in a bid to put enough weight on him to last until his stomach could heal.  
Through the port in his groin, the solution, made of lipids and vital vitamins and nutrients, allowed Jim to get the baseline nutrition to stay alive. At least he couldn’t throw it up. Jim had continued to lose weight, but, praise the lord, at a much slower rate. Putting anything directly into his heart was dangerous but the little hope given by the TPN had been enough to keep McCoy going and Jim alive.

Starvation had made Jim’s recovery much more prolonged. The radiation damage was still extensive. It had caused damage to nearly every organ, compounded by the loss of oxygen for almost an hour while he was dead. The radiation had also weakened his bones and caused cell damage in nearly every part of his body. They had been tirelessly fighting the effects with little success; tumors kept forming, blood wouldn’t clot, and his muscles and bones were perpetually brittle. As quickly as a regen unit could be implemented, cells would mutate and more DNA and organs would begin to show renewed signs of damage. It seemed to be an endless, futile battle. Progress theoretically had been made: Jim’s organs had finally begun to function on their own; however, the constant risks of infection, the cancerous cell mutations, and his incredibly fragile organs meant that all progress could be destroyed at any time. 

Khan’s blood had been a double-edged sword in this fight. It had brought him back, even kick-started his bodily functions, but the price was terrible. Jim’s immune system, as sensitive as it always had been, simply couldn’t take the foreign blood. Not quite human, not quite natural even, the blood had caused a major immune response, almost killing the captain. The ensuing coma was initially accompanied by hourly seizures, and daily anaphylactic events. As the “super blood” healed cells, and created healthy ones, Jims immune system attached them and made the damage even worse. The first few weeks were incredibly rough but with a mixture of immunosuppressants, blood transfusions, and “super blood” dilutions, the blood therapy began to work faster than Jim’s body could react. It was a miracle that anything was left of him, though. With radiation destroying him from the outside in and his own body from the inside out, any maneuver was a risk

The hot, southern sun was beginning to set, casting the room in blinding yellows and reds as it shown its last, strong rays into Jim’s room. It shook McCoy from his thoughts, reminding him how long he had sat, unmoving, by Jim’s side, without food or water. He was certain that Ali and others had been in and out but since Jim had been stable, McCoy paid no mind.  
The pangs of hunger were finally penetrating his full brain, so, reluctantly, looking at Jim’s peaceful sleeping form, he called Ali to relieve him.

“Sure thing Len, I’ll be right up, you go along.”

McCoy hoisted himself out of the chair, legs cramping from disuse. Suddenly, everything was getting fuzzy, tunnel vision was obscuring even the biobed nearby, and McCoy could feel himself stumbling and falling towards the door.   
Thank God I won’t fall on Jim.  
McCoy never felt his head hit the ground.


	7. On Your Back, Powerless

**Summary for the Chapter:**

> McCoy had pushed himself to the very edge caring for Jim, now the damage is catching up with him.  
> It will take more than just medical intervention to patch him up, though. Sometimes mothers are the best medicine.

**Notes for the Chapter:**

> It's finally happened!  
> Mrs. McCoy (a personal favorite character) is finally, FINALLY introduced in this chapter. It was hard to write honestly, but I hope I do her at least some justice. I'm sure I'll get better but let me know what you think.
> 
> I feel like I don't thank you guys enough for all the love and support you give me so thank you a million!  
> I hope this nice, long chapter is some repayment for all the encouragement!  
> Love you!
> 
> Question: do you guys think the swearing matches the story/setting? I just figure most adults swear in real life, but I don't really know how it fits.
> 
> As always please let me know what I am doing wrong and doing right!  
> Thanks!

McCoy returned to consciousness with a sharp, painful intake of breath. The muscles down his back protested as he tried to hoist his pathetic body off the ground, but found himself unable to move. Blinking furiously, trying to get the spinning world back into focus, McCoy looked up to see Ali holding him down, a whole crowd of doctors and nurses surrounding him.

“What in the living fuck just happened?!” It wasn’t more than a croke, the metalic taste of his own blood already filling his mouth as his bit lip became very apparent.

“It would seem that when you tried to get up you passed out, Len...”

_Well I’ll be fuckin’ damned_

This was very, very bad. How had he fallen apart so easily- and quickly?  
What the fuck would this mean for Jim?

“Ok, let's try to get you up, slowly now. You seem to have given yourself a good whack on the head so we’re gonna put you in a bed and get a looked at ya?”

Ali loosened his grip on McCoy enough to allow nurses to help him lift the man onto a stretcher. McCoy’s brain was still foggy and thinking was painful but the reality of his situation was becoming apparent and the embarrassment was starting to spread.

The trip into a private room was both familiar and incredibly foreign; McCoy had transferred plenty of patients but had never been wheeled through the hospital on his back before. The self consciousness at his idiocy and vulnerability made him feel sick and dizzy. Or maybe it was the concussion?  
He was able to keep from throwing up until he made it to a quiet room, alone with just Ali and Carter.

After retching for several more moments, a painful reminder of his empty stomach, McCoy was able to lay down. The click of the biobed lowering over him made him cringe, as did his colleagues eyes.

“Let’s get a look at your head” Carter pulled on gloves and began to examine McCoys head with a familiar professional detachment.

Ali took his place beside Carter, watching both the readouts of the biobed and the scanner pointed directly at his head.

They were gentle and efficient but McCoy felt like a sick sort of spectacle, not at all dignified, definitely not their peer.

_Jesus, is this how Jim feels when I’m around?_

It was dehumanizing, but above all else it was scary and embarrassing.

Craning his neck to snatch a glance at the bio readout, McCoy was hit by a pain in the back of his head and another spell of dizziness.

“Well you gave yourself quite the concussion, Len…" Finally someone made eye contact with him

“Luckily there is no bleeding on the inside, just an old fashioned wack. You did split the back of your head open pretty nice though, nothing a regen can’t fix in minutes, but a damn nasty one.” As Ali spoke Carter was already sanitizing the area and applying the regen unit.

The pain and nausea was quickly setting in again, closing his eyes McCoy tried to focus on the important stuff.

“You’ll take care of Jim? Maybe just tell him I had to go home?”

Opening his eyes long enough to stare seriously at Ali for a moment,

“Ali, don’t let anyone else take care of Jim. Please be there when he wakes up. Don’t worry him too much with me.”

“Sure thing, Len.” Patting the man on the shoulder, Ali turned on his heels and left the room.

“So Tom, when can I get the hell out of this place?” Gestured vaguely at the biobed without opening his eyes.

“I can’t honestly say. At least overnight. You’re pretty damn dehydrated, sleep deprived too. You’re starting to look as starved as your patient.” Carter eyed McCoy nervously before sitting down beside him.

“You know, if you don’t start taking care of yourself pretty quickly, your ability to care for Captain Kirk will be called into question.”

“Ali will be forced to report this incident to Starfleet in the morning. The best thing you can do is show an effort to recover.”

If McCoy thought his head was hurting before… The thought of Jim being taken away sent a lightning bolt of pain radiating down his spine, involuntarily clenching every muscle in his body.

“You need rest Len, and quiet, and food, and water, and all the things you’ve been depriving yourself of since your captain was injured.  
It’s more than evident by your blood results that you have been running on empty for some time. No, McCoy, stop craning your damn neck! 

Your magnesium is incredibly low -no wonder your muscles are spasming. I don’t know how you’ve managed to keep going as malnourished and dehydrated as you are.” Carter paused looking at the pained expression on his now-patient’s face.

“We can patch you up quickly enough Len, but you need a good night’s rest and an IV, no arguments.”

The exhaustion hit McCoy like a wall, through its dazing weight, now resting on his face and chest, he barely felt the Carter insert the IV.

Sleep overtook him before he could say another word or protest.  
For the first time in weeks the sleep was real, and comforting, and peaceful.

_____

McCoy started awake suddenly, his chest hitting the biobed arch unintentionally.  
For several moments he lay in a daze, unable to open his eyes due to the blinding white light of the room; an unfamiliar room, but not too unlike…

Jim! 

This time when McCoy hit the biobed it was in a deliberate attempt to break free from a bond he couldn't yet quite see or understand in his groggy state.

“Leonard!” Now that voice...

“Lie back down right now or I’ll call the doctors!” The hand now resting on his chest was familiar, as was the repremendaing voice… much too familiar.

Oh no.  
Momma.

His eyes opened again, wide despite the glaring sun.

Elanora McCoy, all 5’2’ of her, exuded the fierce love and annoyance only a mother could possess.  
Hands on her hips, she surveyed her child, her adult child, flat on his back in a hospital bed. She wished she could have been surprised, but he had been in Atlanta for over a week now, and him not visiting could only mean that he hadn’t taken a moment for himself since arriving.

“Hi Momma” he said, like a sheepish child.

“Oh baby… Just look at you, you’ve run yourself absolutely ragged!”

Damn, McCoy’s throat felt dry, and he was hungry, so fucking hungry. This was not the time to try to explain to his mother why he had somehow ended up in a hospital bed with a tube in his arm and blood in his hair.

There were things to prioritize.

“Jim?”

“He’s fine pumpkin. He woke up for a bit, a ‘lil surprised not to see you but calm, according to the kind Dr. Ali, but after some regen therapy I think he’s gone back to sleep.”

“How long have I…?”

“Almost 12 hours baby, it’s just about six now. Enough of these questions though, Leonard; it’s time we got some real food in you.” 

Momma had always been the best damn cook around. The red beans and cornbread, orka and his favorite pie, it nearly made him faint all over again.  
He’d missed real food, there was nothing comparable in space or San Francisco for that matter.

“Eat up child, you and I need to have a real chat but I don’t know if you’ll last that long if we don’t get somethin’ in you first.”

Raising the bed and disengaging the arch with the practiced ease of an experienced nurse, Mrs. McCoy situated the food in front of her son before wiping blood from his forehead and sitting back to let him eat.

McCoy’s stomach was stuffed to the point of bursting before he pushed the plate aside. Sitting back, he ran his hand through his hair, the gash was no longer there, praise the regen, but the clotted blood still left in clumps made him cringe.

“Let’s talk Leonard, then you can go get a badly needed shower.” Elanora smiled kindly but there was something sad in her eyes.

“What in God’s name are you doing Leonard? How did you let it come to this?” This was not exactly what McCoy expected but he supposed he had it coming.  
His headache was already returning in ernest.

“Momma… There were more important things-”

“More important things! You think you’ll be any use to poor Jim flat on your back in a hospital bed?!”

Damn his head hurt. What the hell was even in this IV if his head still felt like it had been blasted clean through?

Mrs. McCoy calmed herself and put a comforting hand on Leonard’s shoulder.

“You know I love you Lenny,” McCoy grimaced at the childish nickname, “but you’ve clearly been burning the candle at both ends way too long, and it’s going to get you in trouble.”

“But Momma, I can’t leave Jim here! You know how he can be. He’s gonna die without me…”

“I don’t think there is another option baby, at least not for now.” Petting his hair and stealing herself for what was coming next.

“I’ve talked to the doctors, the nice starfleet one, Ali, said the higher ups are concerned but are willing to consider releasing the Captain into your sole care at my home as long as you spend no more than 8 hours at a time in the hospital for the next week and show significant recovery.” 

McCoy felt relief, and fear, and guilt in a single, paralyzing moment. It was extremely lucky that he hadn’t been taken off Jim’s case entirely and that they were still considering his transfer to Momma’s house; but, Jim needed him more than 8 hours a day, much more. This was a pivotal point in his recovery and if McCoy had fucked that up he would never forgive himself.

McCoy’s stunned silence was interrupted by Dr. Carter entering the room.

“Ah, Mrs. McCoy, so nice to see you again, I was hoping you’d come get Len and set him straight.” Carter’s easy smile emerging as he greeted one of the best nurses Atlanta General had ever had. 

Glancing at McCoy his smile faded. The man’s face was gaunt and white, he must have heard the news…

“It’s really not such a bad deal Len, when you’re gone I promise ya we’ll take real good care of Jim.”

As Carter gently detached the catheter in his arm, all McCoy could feel was emptiness. It would seem that he didn’t feel like much of a person at all if he wasn’t Jim’s doctor. 

“You’re free to go Len, get up real careful though, and mind you keep eating and drinking or you’ll be back in hear faster than a cat on fire.” His firm hand on McCoy’s weak-feeling one was only more disheartening. 

“Jim will be real excited to see you.” Carter helped McCoy out of bed, watching for any more signs of faintness, before leaving with a last,

“You take care of him, Mrs. M!”

“Now come on honey,” Mrs. McCoy gently guided her son towards the bathroom, “lets clean you up a bit and then you can go see Jim. You’ll have a proper shower when you get home.”

McCoy felt like a child, felt angry and defeated, but begrudgingly did what he was told. One did not say no to Elanora McCoy.

**Notes for the Chapter:**

> Its funny how even just making art (writing) can be inspiring to oneself.  
> I've been thinking a lot about medicine lately, partially because of my obsession with writing this story correctly, and have been considering returning to school to do pre-med in the hopes of becoming an actual doctor (a childhood dream). What do you guys think?
> 
> I have been out of school for a year or so but I was passionate about science in college while I was there and very high achieving I just don't think I was confident enough in myself to aim that high. I'm really scared of being too old as I'll probably be going back around 22 and that will be weird.
> 
> Sorry for the rambling about personal stuff!
> 
> Thank you all!


	8. The Blame of Good-bye

**Summary for the Chapter:**

> McCoy says goodbye.  
> Thinking in absolutes damages everyone, but is a habit so very hard to kick when you constantly dance the line between the absolute everything of life and the absolute nothingness of death.

**Notes for the Chapter:**

> Thank you all again for your endless, incredible support! I am blown away every time!
> 
> I am hoping to put out a chapter every weekend at the very least with maybe some little updates added in. Hopefully a more regular schedule will help me push this story along plus you guys deserve consistent updates!
> 
> Here is a note on how some of this story should be read:  
> Jim doesn't understand what exactly happened to McCoy so he doesn't have the context for why McCoy is so upset that he has "failed" Jim. This makes Jim feel even more guilty and scared because it seems as if Jim has caused more damage to McCoy than he really has and so McCoy will leave him in a much more significant sense.  
> I am not sure if this is very clear in the story but hopefully this helps!

The walk to Jim’s room filled McCoy with a deep, cold dread. He couldn’t imagine a scenario in which he could tell Jim the truth and prevent the kid from feeling responsible for McCoy’s own damn actions.

If it wasn’t for his mother marching him down the hall, McCoy would most likely have found some place to hide out until he could return to his work without scrutiny. 

As it was, McCoy took a deep, forced breath, pausing in front of Jim’s room for a moment before his mother gently rubbed his shoulder, nudging him into the room.

“Hello sunshine.”

McCoy’s carefully curated shield of humor and prickly sarcasm was the only thing keeping him from a breakdown in front of Jim. At all costs he must keep Jim’s mood up, his life depended on it.

Hearing his doctor’s voice, Jim uncurled himself from his hunched position, straightening his face from a crumpled mess of fatigue and concern into a weak grin.

“Bones! I was wondering if you would ever come back or if you dashed for good!” It was meant to sound like a joke, but McCoy wasn’t that shit of a doctor; there were few things that truly scared Jim, being abandoned was one of them.

“Nonsense Jim, you’d have to kill me yourself to get rid of me.” His voice was casual but his physical examination was a gentle apology for leaving Jim alone all day.

After reassuring himself that none of the other stone-aged doctors had hurt Jim, McCoy stood back enough to allow his mother to step forward.

“Mrs. M!” God, he’d forgotten how Jim look when he really smiled. He only wished that his face wasn't so much like a stripped skull.

“Hi baby” Mrs. McCoy was motherly to everyone but there was a special place in her heart for the orphaned and ill. Besides, seeing how her son loved and cared for this kid, Mrs. McCoy would always have a home for him.

“Goodness, you look a mess child.” Instinctively she straightened the rumpled bed sheets and wiped his face.

“You shouldn’t be bent over like that, you’ll give yourself a chest infection!”

Sometimes it was remarkable how similar the McCoys really were.

Mrs. McCoy continued to fuss, commenting on the state of his hair and how he needed more blankets. She was tactful enough not to mention his drastic weight loss or the tubes, instead busying herself, only saying something about finding blankets before purposefully leaving the room.

McCoy continued to look at the monitors, the IV site, Jim’s Chart, anything except his friend. He had let Jim down in the one way Jim could not handle: he had abandoned him when Jim needed him most.

“Bones…?” Jim couldn’t understand what was going on. The painkillers made his head fuzzy and heavy but through the fog apprehension was beginning to build.

Struck by the sudden memory of his colleagues around him, treating him like a regular patient, ignoring him when he was scared and confused, McCoy looked up, making eye contact with Jim.

“Jim… I’m so sorry.” Running his hand through his slowly graying hair, McCoy had to admit he was beginning to feel old. 

_ This kid is sending me to an early grave. _

“Things are going to have to change for a bit. I have to go home now, Jim.” He couldn’t bare to look his patient in the face.

“Not for long!” McCoy added quickly in response to Jim’s sudden intake of breath.

“I’ll be back in a few hours. I’ll still be here every day, but Starfleet wants me to get some rest before we take you back to my Momma’s house. It’s all bullshit, I’m plenty rested but you gotta do what Starfleet commands.” He smiled tiredly, trying his best to make the situation sound less serious than it was. Jim didn’t need all the messy details.

It didn’t matter though.

The realization of what Bones’ life must have been like for the last several weeks struck Jim like a phaser stun. He had barely been conscious for most of that time, and when he was the pain and weight of his own life had selfishly preoccupied him. He had never even considered the whole ordeal he had put Bones through.

Jim was silent for a bit too long before looking up and saying,

“Oh.” 

McCoy’s heart plummeted. 

“I’m so, so sorry Jim. Its only for a week, and then we’ll take you home to Momma’s. I’m still going to be here, It just can’t be 24/7 anymore. I am sorry I failed you, kid.” The rush of words out of his mouth made McCoy’s insides tighten. Blinking furiously, he took a shallow breath and regrouped. He had never been this out of control in front of a patient, let alone in his own damn old hospital.

“You’ll be fine Jim. You can call me anytime.” McCoy indicated the rarely used PADD beside Jim.

“Listen to Ali and the others. They are under strict orders to leave you be when I’m gone. No big procedures with them, just the little stuff.” He nervously rearranged the tubes and fiddled with the biomonitors. 

“I’ll have them give you a bath so we can start---”

“No!” Finally Jim came back to himself.

“Just have them leave me alone! I’m fine! Just… I’ll see you tomorrow, right? Tomorrow then.” Jim lay back in his pillows, not looking at Bones, trying not to cry. 

He didn’t want to be a burden. He was ruining Bones’ life and he had been so selfish, so  _ stupid,  _ he hadn’t even noticed and now he was going to get turfed off to these idiots who didn’t want him and couldn’t care less about him.

“I’m sorry Jim.” McCoy hated repeating this over and over but it was true, and what else could he say?

“No McCoy!” McCoy’s blood ran cold, it had been years since Jim called him that.

“Stop being so fucking crazy, this is MY FAULT, now go home and get them all to leave me alone.” Closing his eyes, Jim ignored the pain blossoming in his chest and tried to block out the rest of the world.

His outburst was embarrassing. He just wished everyone would leave. He was so tired of fighting.

Why couldn’t they have let him die? Why bring him back to this hell of hypos, alarms, and sterile air?

If McCoy cared so damn much, why was he doing this to Jim AND ruining his own life too?

Why?

Stunned by this first real display of anger, of any emotion, McCoy reflexively grabbed Jim’s hand, holding it tightly until the pain prompted Jim to reluctantly look up at him.

“I am not leaving you. I will be back tomorrow, and you  _ will _ be ok. Nobody will hurt you Jimmy, or you know I’ll send ‘em to hell before God can lift a finger."

He didn’t let go of Jim, but loosened his grip as Mrs. McCoy entered the room with blankets and Dr. Ali in tow.

Jim’s eyes were closed, he listened to the people around him, barely daring to move or breath so to not cry or bring attention to himself. 

“Ready doctor?”

“Ali, you know the deal, hourly reports!”

“Damnit Leonard! You are supposed to rest!”

“Momma-!”

“Don’t worry about it Len. We’ve got it from here.”

One last gentle squeeze of his hand and the weight of the new blankets over him were the only goodbyes. 

The rest of the words, jumbled and frightening, but not altogether foriegn, swam in Jim’s fuzzy head before disappearing into blessed darkness. This time he didn't care to protest.

**Notes for the Chapter:**

> What do you guys think of my dialogue? I am trying to get better at natural pacing and 3+ person dialogue so I can always use critiques and pointers!
> 
> Thanks lovelies!
> 
> P.S.   
> Thanks for your encouragement about med school! I am really hoping to go back to school fall 2021!


	9. Home at Last

**Summary for the Chapter:**

> As well as being tired and starved, McCoy finds himself devastated and conflicted upon leaving Jim to return to his mother’s home. He is forced to reflect on what being Jim’s physician has done to him, and to face Spock’s hard questions.

**Notes for the Chapter:**

> Late again! Sorry!   
> I have been super sick and had to continue working so its been slow going. I think the chapter is pretty great though so enjoy!
> 
> I have also left some background information regarding McCoy's family in the bottom comments in case there is any confusion.  
> As always, please let me know if you have questions, requests, or corrections. I always appreciate it!
> 
> Thanks again for your patience and support!

The quiet of the car was defining as they traced the long, country roads back home.

McCoy’s guilt about leaving Jim was very slowly being mixed with anticipation to be back in his mother’s house with real food and a real bed.

Despite his exhaustion and desire to be home, his mind, forever working to keep Jim alive, was racing at an unstoppable pace.

“Darlin’ what’s the matter?” With the autodrive already engaged, Mrs. McCoy turned her seat to face him.

“What-?” McCoy started subtly in his seat, returning to reality.

“Baby, you’ve been bouncing your leg like crazy since we got in the car. Did the doctors put caffeine in your IV?” She smiled fondly at her tired son. 

It didn’t matter how little McCoy had slept, he was wired. The thoughts of home ahead of him where haunted by Jim and how alone he was at the hospital with strangers around him.

“You’re worried about James?” Momma always knew.

“He’s going to be fine baby, he’s got Atlanta’s best on the case and you’ll be back in the morning.”

“But-” There were so many things that could go wrong. Jim wasn’t an ordinary patient.

“No buts, you need rest Leonard!” Mrs. McCoy’s pat on the knee was a gentle, but firm, reminder of why he was required to go home.

“There is a lovely warm bed waiting for you and a certain child eager to see you tomorrow. You do have a life outside those doors, baby.”

_ Jojo! He had carelessly forgotten one of his most important personal reasons for coming here. Between is role on Enterprise, saving Jim’s life over and over, and losing control of his own, he had neglected his daughter once again. _

“Damn, how long have I been here? Is Jojo mad at me?” McCoy ran a hand over his face, scolding himself internally.

“Of course not, but she is anxious to see you, she asks every day.”

“I bet Joselyn is loving this.” Mouth set in a grim smile.

Mrs. McCoy made a face of annoyance at Leonard’s ex-wife’s name,

“It won’t do to worry about any of this now, we’re home.” 

McCoy gathered his few possessions as the car came to a halt in front of his mother’s comfortable, country home. 

Atlanta’s lights could be seen illuminating the horizon but the clear air and the rest of the dark sky removed the chaos of the city from McCoy’s mind temporarily. It had been a long time since he smelled real country air. Nothing could compare to it. Hospitals and starships have eerie, dead smelling, air that one can never quite escape. But here it was fragrant and humid; it smelled like home.

His childhood house stood large and pale in the moonlight. As momma unlocked the door, the lights automatically illuminated the bottom floor. It hadn’t really been long since he had stepped into the massive kitchen, but it felt like ages. It had an air of peace and comfort he had never been able to replicate. Not with Joce, and definitely never in his tiny apartment in San Francisco or his crew quarters on Enterprise. This was his first, and always, home.

“Now darlin’ why don’t you go upstairs and take a shower and I’ll make you something to eat. Remember to wash the blood out of your hair, it's a right mess!” 

With heavy feet Leonard trudged up the stairs as instructed.

Shaking her head contemplating her poor, disheveled son, she began to prepare toast, over-easy eggs, and chamomile tea. Home medicine like this was the only thing to set him right.

  
  


The hot water gushing over McCoy felt like the warm, solitary blanket he had desperately needed for so long. The misted pressure showers on Enterprise were built for efficiency as were the power wash showers in the hospital; they gave no consideration for relaxation or comfort. This water was hot, and full, and a luxury he seldom had. He couldn’t even remember the last shower he had taken at his own home. There had never been time; always a dash to grab clean clothes or some other necessity before Jim woke up again. 

As much as he didn’t want to admit it, he needed this.

The indulgence of it all brought on another wave of guilt. Maybe it was the hypoglycemia or the sleep deprivation, or maybe just the hot water, but the guilt hit him like a physical wall. Feeling light-headed again, McCoy sat down in the shower, rubbing frustratedly at the blood in his tangled hair and trying to breath evenly.

How could he be enjoying this while Jim was alone in the hospital, in desperate need of a shower himself?

He shouldn’t be here in the first place. If only he wasn’t so fucking careless and stupid...

Mingling with the old blood and water already running down his face, the tears seemed more understated. He barely registered them before a sob shook him. 

_ Leonard McCoy is not a man to cry like this! I am a doctor, a professional. I should be able to handle this easily! What am I becoming? _

Trying to mask the sobs with slow, halting breaths, McCoy did his best to invoke his training and regain a sense of detachment from the ongoings in the hospital. But even as his professional brain struggled to retain control, the deeper part of him, the part that was a sarcastic drunk and a loyal friend, reared its ugly head and an even heavier wave crashed over him.

McCoy had spent so many continuous hours being Jim’s Doctor and grieving the situation as such that he had never given himself time to acknowledge the pain as Jim’s friend. He was too seasoned to be scared by the IVs and monitors, but Jim’s skinny, sober face… It was absolutely haunting, nothing like his friend at the Academy, nothing like his Captain. 

Nearly losing Jim over and over again had been scary as his Doctor; but now he was washed in the fear of watching a man he trusted, and respected, and cared for just waste away. McCoy had much too often looked at Jim smiley as his patient these days. His gentleness indicating more of his medical concern than his concern for his friendship. 

What if Jim didn’t survive? What if he died feeling as if McCoy now only cared for him like any other patient, going home without a care? Even if Jim did survive could they ever regain the friendship? Had McCoy gotten too close, while still being much too far away?

Already feeling the hot water begins to dwindle, McCoy tried to push the panic down in his chest and reluctantly hoisted himself up, slowly this time, to prevent falling again, and exited the shower. 

Downstairs the smell of food was almost overwhelming and was quickly devoured. 

It brought back strong memories of McCoy as a child, in pajamas while sick, eating the same food, in the same kitchen. On one hand it was comfortingly similar, on the other hand McCoy felt humiliated and furious at himself. He was a grown man! A successful doctor with a desperately sick patient! He had no right to be cared for like a child when there was work to be done!

_ Ah yes, maybe his professional shield was coming back.  _

“Stop that scowling Leonard! Your face is going to stick like that. As if you don’t scowl enough. Not in my house!”

“I’m sorry Momma…” It used to be that McCoy apologized to no one. Now he did it all the time. Momma was always an exception though.

“This is absolutely insane, I should be back at the hospital already! I’ve eaten and showered and slept all damn night and day, what else do they want from me?!”

“Sweetheart… You are working yourself to the bone. You can’t keep burning the candle at both ends. You need to relax for a bit, rest. You’ll feel better and that will help James get better.”

McCoy sat back, defeated. He couldn’t reject the orders from Starfleet  _ and  _ his mother.

“I need to go upstairs. Clear my head. Thanks for the food Momma.” McCoy rose from his seat heading towards the door before stopping suddenly,

“And thanks for doing all this for Jim. He needs it more than you know.” 

Mrs. McCoy watched her son fondly as he disappeared up the stairs. 

He had always been like this, a workaholic, intensely devoted to his patients. It was one of the reasons his marriage with Joselyn had failed, the other being that she was a vicious bitch. Elanora had never liked Joselyn, but in this moment empathized in her frustration with the man that would stop his work for nothing, to the point of collapse.

Elanora longed to have her Leonard home, but his pale, tight face… This was not the son she remembered. Even in his anger after the divorce, he had never looked so sad and ill. James’ injuries had broke him more than anything she had ever seen. She couldn’t fathom the seriousness of the situation and yet she would help with whatever came her way. It was forever the life of a mother.

  
  
  


\---

  
  
  


McCoy was just laying back on the bed, hoping to sneakily review some of Jim’s charts when his PADD alerted him Spock was calling.

_ Dammit! Now what?! _

Sitting up a little straighter in bed, McCoy ran his fingers through his wet hair and tried to look awake.

“What do you want Spock? I’m trying to go to sleep, dammit!”

“I apologize, Doctor, but this is urgent.” If McCoy didn’t know better he’d say the Vulcan looked a bit offended.

“I received word from Doctor Ali and Starfleet about your incident earlier today and was just informed of your arrival to your mother’s residence. I must say I was expecting much more frequent communications, Doctor.”

“Well that’s a little bit difficult to do when I’m saving Jim’s life every goddamn day!”

“I understand, Doctor, but remember I am representing your endeavor here at Starfleet and they are displeased. It would be in Jim’s best interest, as well as your own, to keep me apprised.”

Given Spock’s tendency to under exaggerated, Starfleet must be madder than a hornet in a pickle jar. McCoy supposed he was lucky he only had to talk to Spock and not any of Starfleet’s stuffy admiralty.

“Doctor? Will you please inform me of the current situation with your health and the Captain's progress?” It was not a request.

McCoy signed, he didn’t want to think of any of this now. If he had to be away from Jim he just wanted to fucking sleep in peace.

“Fine Spock.” McCoy took a deep, annoyed, breath before continuing.

“Jim has been able to spend some limited time awake but he is still suffering with a great deal of pain. We are pumping way too much painkillers into him but we don’t really have a choice. Since we’ve been in Atlanta for about a week now, I believe, that means he hasn’t had a full course of blood therapy in 10 days. He was due for another one today, but they postponed it for me…”

The Vulcan looked impassive as he listened, a trait McCoy hated; however, it barely mattered as McCoy was looking anywhere but at Spock.

“He’s still not improving much, Spock. I don’t look forward to the blood therapy. I know Khan’s blood works wonders but it does so much damage, even as it heals him. With all the other setbacks, the blood therapy delay means that more cell mutation has occurred and we will be dealing with post-radiation issues as well as the usual immune responses during the therapy course. He needs to start getting better, and quickly. He still can’t eat anything. The NG tube is a no go and the TPN is working much too slowly. He’s starving Spock… And its giving him nightmares…”

“Is there anything you can do Doctor?”

The Vulcan must be practicing concern these days, if his face is anything to go off.

“Well hopefully the blood therapy will do more good than harm. After it restarts cell healing functions we can use the regens more effectively for long term healing. We will also be targeting the stomach with additional drug therapies. Things should be worlds better once he can keep food down again. As of now he even throws up water…”

“I see.” 

It was grim, the whole lot of it.

“And you, Doctor?”

McCoy looked away with an exasperated sigh.

“I’m absolutely fine! Just tired. I need rest and to be left alone but everyone wants something!”

Spock didn’t look convinced, nor did he look perturbed by the obvious anger that had seeped into the Doctor’s voice, even surprising McCoy himself.

“Doctor, you should know that Dr. Ali, Starfleet, and I are all concerned for your wellbeing and how that may impact your ability to care for the Captain. I suggest you adhere to Starfleet’s orders to limit your time at the hospital. They are much closer than you may think to taking you off this assignment.”

McCoy’s blood, previously hot with anger, turned ice cold.

“I will be traveling to Atlanta later this week to assess the situation myself before we move the Captain into your mother’s home.” Spock looked grave, the weight of the situation and the fragility he sensed in McCoy were not lost on him.

“Dammit…” McCoy said under his breath.

“Very well Spock, it’s not like I have any say anyway.”

“I am… sorry, Doctor. I understand that this is a most upsetting situation. Please remember, however, that Jim does need you for his recovery. You know this. I will not let them take you from him unless absolutely necessary. Do not make me.”

The humanity evident is this plea took McCoy by surprise. In return, he soberly nodded his acknowledgement.

“Well Doctor, I know you have had a long day, rest well. I will be contacting you with details of my arrival in Atlanta presently.”

With that the screen went black and McCoy sank into his pillows.

Reflecting on the conversation, the idea of his superiors and colleagues worrying for him, the idea of Jim being taken away from him… and him having nothing, being nothing… it was too much to face.

Taking one quick look at Jim’s charts, McCoy dreaded the morning, seeing Ali, and performing the blood therapy. There was little McCoy didn’t dread at this point, except the warm bed and the promise of deep, black sleep.

It had been just over 24 hours since his collapse in Jim’s room, most of it had been spent asleep, or at least in the hospital bed watched closely by his mother. It was more than enough time for McCoy to feel the control, the doctor in him, begin to slip. He just had to keep going. Going for Jim.

There was no more room in his sore head for thought, or worry, or pain as he slipped quickly into darkness.

**Notes for the Chapter:**

> Here is some background info for you nerds incase you are curious :)  
> I took McCoy’s mother’s name from other ff works. While she is never officially named, semi-cannon works have differing names for her. In the game Star Trek: Starship Creator MoCoy’s mother’s name is Louise. Other semi-canon sources will call her Maureen. Due to this lack of consensus and the inspiration I took from other works I made the decision to call her Elanora.   
> Also Joselyn is the name of his ex-wife according to a novel “Shadows on the Sun” by Michael Jan Friedman, though in the abovementioned game her name is Miriam.  
> I would suggest checking out Memory Alpha (the wikipedia of Star Trek) if you want to get the complete history on McCoy and his family.  
> One of the specific fan fictions I have used as inspiration in this work is the amazing piece, “And If I Stand Next to You” by arrowinthesky (restfulsky5) and DiamondBlue4 here on AO3. While my story doesn’t explore the sexual/romantic aspects of Jim and Bones, I still hope to capture some similar emotions and tone of this work. I definitely recommend it to people who enjoy these types of medical fan fics.


	10. Breathe

**Summary for the Chapter:**

> "'Cause you're the one thing I believe in  
> When I lose faith in all I do  
> This paradise comes when I close my eyes; it's true  
> In the darkness I see you"  
> -Breath by Seafret
> 
> Loneliness can be just as suffocating as any sickness, but it is up to Jim's new family to remind him he is not alone.

**Notes for the Chapter:**

> Thanks again for your patience guys! I know I am super slow getting these chapters out. They seem to get longer and longer each time.
> 
> I know you keep hoping that Jim will get better but I can't seem to stop myself from torturing the boys more and more. I'm sorry!  
> I hope you enjoy!
> 
> P.S. My tags will likely be updated soon as the plan keeps changing

Jim tossed and turned within the confines of the biobed, his sleep perpetually interrupted by dreams and lightning bolts of pain. In half-sleep, he would try to remind himself that he was safe, that this hospital was not like the ones before. He had to remember that Bones would never let anything happen to him; however, the comfort of Bones’ authority would only stretch so far to protect the fitful man. He was still alone here.

Every few hours he would surface again from the dreams and medication, raising his head and looking for Bones, everytime the realization that he wasn’t there would send a wave of panic over him. Jim fought to push the panic down, but after so much time with Bones by his side, his absence in Jim’s vulnerable goggy state sparked terror in his mind.

After running into the room several times as Jim’s heart rate and respiration spiked, Ali finally abandoned his call room, instead spending the rest of the night by Jim’s bed, replacing Bones’ form in substance if not spirit.

Though Jim would awake a handful more times, Ali would take a deep breath and reach for the man’s boney hand, hoping to give him some comfort.

In this fashion, the first night of Bones absence passed with very little substantial sleep for either man.

Finally, the liberating rays of the sun penetrated the dark, dreamstate of the room, waking Jim first, who, in typical fashion, remained perfectly still. The moment of morning clarity was refreshing but it didn’t take long for the aching, heavy pain in his chest to rise through his consciousness, taking over.

Curling into a ball, Jim attempted to make himself small and hold his aching arms and legs close. Jim tried to fend off the pain silently, hugging himself and rocking slightly for comfort and distraction.

Pain flared across his groin as the rocking pulled at his central line, disrupting the pump.

The pump’s shrill complaint rang urgently over the coughing sparked by the pain that had now spread through his body and into his already aching lungs. 

Ali awoke abruptly to the alarm, springing to assess what the hell was going on with Jim. Jim did not notice, his world had shrunk down to the pinpoint of pain that was his wretched body.

The pain seemed to continue to move, penetrating his frail bones. His whole skeleton seemed to shake with every cough.

Instinctively, after so much illness and injury, Jim continued to curl up, shielding his face, though continuing to cough.

He could barely move or think through the pain and the waves upon waves of choking that he couldn’t seem to breathe through.

They were getting on top of him, suffocating him.

_ I’m going to die and Bones isn’t even going to be here… boy, will he be pissed _

Jim could barely hear the additional cacophony of alarms begin over his coughing. His O 2 was rapidly declining and the pain monitors were screaming for attention.

It had seemed like an eternity, but actually only seconds after the coughing began, nurses and doctors rushed into the room and surrounded the bed and Ali. As soon as a hand started to pry Jim’s body into an open position, his heart rate spiked critically and he thrashed uncontrollably.

Between the coughs he yelled at them to get away from him.

Remembering the patient he was dealing with, Ali quickly shouted over the commotion,

“Get back!” The crowd minimally dispersed, some waiting, shocked at the state of the patient.

“Call respiratory!”

“Lets get some O 2 and sit him up”

Ali had been mentally preparing himself for this, especially knowing that Len would be forced to spend some time apart from Jim.

Carefully he approached Jim once again, he had to act quickly, the poor kid was gasping for breath he couldn’t find, Ali could see his mind reeling and his consciousness dwindling.

“Jim, it’s Ali, we need you to let us help you right now.”

He gently but firmly grabbed a hold of Jim’s shoulder and boney hip, holding him as he repositioned the man, more upright and open allowing his ribcage to actually expand, still supported in Ali’s arms.

“You’re doing amazing kid.” Ali didn’t let go. Motioning for a nurse to bring the diffusers and oxygen.

He had seen the way McCoy touched the kid, how sensitive Jim was to touch. If someone touched him without warning or consent, he would fight them with no consideration for his own state. The kid would always fight, even at great harm to himself, a trait that shocked and horrified most.

At the same time, touch from McCoy was often the only thing that could keep Jim calm. During the midst of a panic attack or other episode, words did nothing for Jim. Instead McCoy’s hand, not always gentle, but always steady and firm, on Jim’s chest or arm could give him the comfort he desperately needed.

As the mask was fitted over Jim’s face and the steroids were administered, Ali kept his hands on Jim. He continued to hold the man upright as his head lolled slightly and his coughing slowed to short, erratic bursts.

“Ok Jimmy, I am going to need you to take some deep breaths.” Ali rubbed his back, unsure if Jim could even hear him.

_ Dammit, I’m still alive. What shit is this?  _

_ Wait, that isn’t Bones’ voice… _

Jim gasped raggedly and opened his eyes, looking up, tears streaming down his face from the coughing.

Through the tears, Jim could see the dark outline of Ali, not Bones.

“Bones...?” The word alone sent him coughing again.

“Shhh kid, he’s on his way now.”

\---

The call from the hospital was the one McCoy had braced himself for. He just  _ knew  _ the fools were going to fuck something up and Jim was going to pay the price.

Pulling on wrinkled scrubs, McCoy made his way, fuming, down the stairs to find his mother fully dressed and waiting by the door.

“Are we going now?” It would seem she was waiting for this too.

It took a moment to register that his mother was asking to come with, and another to realize it wasn’t really a request.

“Yes! He’s having some kind of coughing episode, the fool’s probably given himself a chest infection!” 

The situation was too urgent to waste time with details as he rushed towards the hover car.

Eleanora worriedly followed after him.

The adrenaline coursing through Bones felt normal and right.

He was ready and anxious to get to Jim the whole way to Atlanta.

McCoy only calmed a bit as they made their way through the city, nearing the hospital.

Realizing his mother’s presence again, he looked up from Jim’s chart,

“Momma… you don’t need to supervise me.” McCoy wasn’t dumb enough to tell his mother to leave him alone, but he didn’t need a goddamned babysitter!

“Hush, I think you and Jim could both use some calm and comfort right now, Leonard. Let me help, you can’t keep trying to do this on your own.”

  
  


\---

Bones entered the room with steady confidence and for the first time Jim was able to take an actual breath.

He had his eyes closed, in a barely conscious purgatory, simply letting Ali keep him upright and letting the fire in his chest consume most of his mind. I didn’t matter though, those footsteps, and that huff when he saw Jim, _ classic Bones _ . 

Jim tried valiantly to open his eyes and greet Bones but the world spun and tears poured out so he quickly closed them, only retching slightly from dizziness.

“Status?” Bones was all business.

“He was sleeping and doing just fine then, for some reason, he seemed to get a pain in his chest and it sparked some severe coughing. He’s been hypoxic and the coughing has only diminished slightly with steroids and O 2 . He’s been semiconscious since we called you, he keeps asking for you but can’t speak much after that.”

“Goddammit! Chest infection.”

“That’s what we were thinking until we got him still enough for a real chest scan… Why don’t we step away?”

Jim could hear Bones talking, but he was talking to Ali, not Jim, and he couldn’t understand what the men were saying. Ali settled Jim back into the bed, removing his last bit of comfort. Now that the touch was gone and he couldn’t see or hear anyone noticing him, Jim felt untethered and completely alone. 

“There looks to be several nodules in his lungs, fluid also, so I suppose we were half right. The nodules could possibly be more radiation-induced tumors, they must be growing at an outstanding rate though since we shouldn’t have been able to miss them in our last full scan.” 

Ali continued in the corner of Jim’s room, shoving a PADD into McCoy’s hands.

McCoy’s face was white as he stared at Jim. 

“Well I’ll be fuckin damned.” 

It wasn’t like this was unexpected, Jim had experienced all sorts of radiation side effects, including some tumor tissue forming; but the tissue had never been deep in an organ before, neither had it required invasive treatment. A tumor in the lungs was bad, very bad. By the looks of the scan, Jim would need a surgery McCoy wasn’t sure he could take; he certainly wouldn't be able to handle the blood loss and heal without his blood therapy first. It was going to be more pain than Jim should have to deal with, not with everything else.

“We will have to do the blood therapy now I suppose, it's been way too long. This is my fault” All business once again, McCoy did his best not to look shaken by the news, and angry at himself.

“I agree, I’ve scheduled him an OR for the transfusions in case things go south quickly.” Ali looked grim and tired.

“Commander Spock got intouch this morning, he will be arriving tomorrow to meet with you before you come back to the hospital.” Ali continued.

McCoy rolled his eyes, then suddenly remembered his hospital restriction. Heart sinking he looked desperately at Ali, pride aside.

“You  _ have _ to get them to lift this restriction. With Jim in this condition I need to be here.”

“I’m sorry Len, but you know it's for the best. You have great people here looking after him. I promise I will be on call the entire time you are gone. Hell, I’ll be right here by his side.”

It didn’t make McCoy feel any better, but it was something at least.

“And once Commander Spock gets here he will watch Jim too. I will have to leave soon, though, I’ve been here for nearly 50 hours and I might be the next to keel over if I don’t get some sleep.” 

At least Ali had a good head on his shoulders. He was talented and reasonable but McCoy didn’t trust anyone with Jim and Ali knew it.

“He’ll be fine, Len. We won’t do anything extreme without you.”

McCoy just shook his head sadly as they continued to discuss the blood therapy and subsequent surgery before them.

\---

Floating, disoriented, and alone, Jim couldn’t help but feel abandoned. Even Bones wasn’t talking to him.

“Hi baby,” 

Jim was startled by the voice next to him and the cool hand on his cheek.

“You’ve had a rough night, haven't ya?”

_ Mrs. McCoy. _

Jim sank into the bed, breathing his second real breath of the morning, a breath of relief. It felt like he had been alone, drowning, for far too long; but Mrs. McCoy was here now, and real, and best of all she was talking to  _ him. _

  
  


“Tell me how you've been, honey?” Trying desperately to open his eyes and pull himself upright, he was hit with another wave of spinning nausea, triggering a body-shaking cough.

“Shhh baby,” Mrs. McCoy gently placed a hand on his heaving chest, lightly holding him down.

“It’s ok, don’t you worry about anything else but that breathing.” Adjusting his oxygen mask, Mrs. McCoy settled herself next to him.

“In and out baby, in and out '' Silently waving off her son, anxiously approaching to intervene, she held Jim’s hand, gently squeezing it in time to her exaggerated breaths, reminding Jim todo the same.

Once Jim had regained some of his breath, though still wheezing loudly, he again stubbornly tried to move and see. Anticipating this moment, Mrs. McCoy stood up and held him in place, all while stroking his arm comfortingly. Unfortunately, she was not quick enough, for his sudden jump to action caused him to squeak in pain and begin retching. Only slightly surprised, Mrs. McCoy produced a small container for him to throw up whatever mucus had accumulated in his empty stomach.

Tears were liberally streaming down his face, pockmarking the mucus-throw up below him, so obviously streaked with blood that even across the room, Bones could see.

Defeatedly laying down, he didn’t even have the strength to wipe the tears away.

“Very good job, James.” Mrs. McCoy said gently, once again settled by him, put her hand on his to remind him not to try anything else.

“Now then, why don’t you try to tell me how you’re doing today, slowly this time.” 

She said it so caringly and matter of factly that Jim was caught off guard. It had been so long since anyone really talked to him, since  _ he _ had really talked much. He had barely been conscious for most of the time in Atlanta and even when he had been the only questions he got from Bones and the others were about his injuries or pain or some other horrible thing to-do with his broken body; they never asked him how he as a person was, infact, nobody spoke to him like a person these days.

Mrs. McCoy was so loving… So motherly. This was so much more than Jim expected. His real mother had never been very motherly herself, but in a sad sort of way he missed her and the comfort of someone who loved him. She hadn’t visited him; she was still in deep space after all. Jim was sure someone told her, but it hardly mattered. The way Mrs. McCoy talked to Jim felt overwhelmingly loving. Maybe he wasn’t as abandoned as he felt.

The tears hadn’t even stopped when new ones replaced them, this time not out of pain or coughing, but a wave of emotion that Jim couldn’t mentally, or physically, express. 

Without meaning to, Jim somehow let out a choked sob, his first divergence from silent tears.

Hearing Jim, McCoy could no longer stand back. He rushed over to the bed, fear in his heart, desperately looking at the monitors for some indication of the cause of Jim’s crying.

Sternly Mrs. McCoy tugged on the sleeve of her son’s coat, nodding at Jim and whispering,

“Stop being his doctor for one second, Leonard!”

McCoy looked surprised for a moment before the realization hit him and he crumpled into the other chair beside Jim.

“Hey kiddo,” The world was disappearing and only Jim and his tears mattered now.

“What’s up?” Jim cried harder, he was finding it hard to talk or breathe.

“I’m sorry, I’m sorry, I’m...s” Jim managed to choke out, between sobs and gasps.

“Wha...? What Jimbo? What are you sorry for?” 

Jim started to talk again only to bring on another wave of coughs.

“Shhhh, just try to breathe. I am the one who should be sorry, Jim.”

“I shouldn't be leaving you alone and being so clinical with you. I know this is a lot and you’re lonely and overwhelmed. I knew, and I still only concerned myself with your physical state.”

McCoy traced steady circles on Jim’s hand, trying to keep him calm while internally wondering what in the world Jim could be sorry about.

“Don’t speak Jim, just try to calm down.”

Jim weakley shook his head before spitting out words between coughs,

“I’m… Sorry you have too… deal with me like this…” It was so humiliating for Jim to need so much care, need so much from Bones, do  _ so  _ much crying.

McCoy wilted in his seat. The kid couldn’t possibly understand the role caring for Jim played in his life. Jim was feeling guilty for things he had no control over, meanwhile McCoy was so deeply guilty for failing the vulnerable man. 

“Oh Jim, you silly fool.” 

_ There's the real bones, if I could laugh I probably would. _

“After all your stupid injuries you’ve somehow made me enjoy caring for you. Don’t give me that shit, kid.”

Jim managed a weak smile, half grimace, but it lit up McCoy’s heart nonetheless.

Leaning in towards Jim, McCoy whispered,

“With all the trouble you get into, I will always have to be your doctor, but don’t forget I was your friend first.”

Jim relaxed, his muscles noticeably less tight.

“Thanks Bones.”  _ That _ was a smile.

Jim was breathing somewhat regularly now, his heartbeat slowly slightly and obvious signs of sleep overtaking him. McCoy breathed a sigh of relief, the kid deserves a pain free nap before his therapy.

“Don’t worry Jim, I’ll be right here when you wake up.”


	11. Blood

**Summary for the Chapter:**

> Jim undergoes a therapy using Khan's blood to try to repair some of his radiation damage. Being the stoic captain that he was born to be, Jim refuses to be put under, instead enduring the pain. It is his body afterall, and there is always something freeing about making your own choices.

**Notes for the Chapter:**

> Well this one is quite the monster. I have been brutally sick and this one has taken forever to write. It's a rough one but I hope it is somewhat enjoyable nonetheless.
> 
> Love you guys!
> 
> EDIT: I apologize for the confusing editing in this chapter and have hopefully sorted it out a bit now! Let me know if its any better!

The shining white and polished metal of the operating room blinded and overwhelmed Jim. It had a calm, almost ethereal, nature about it, even if it made him squint his eyes and made his head spin; the rest of his surroundings however, clashed terribly with the white nothingness, people bustled all around, paying no mind to him, only to the machines chattering loudly.

Feeling the first pinpricks of fear, Jim looked for a friendly face anywhere in the loud, white space. He couldn’t quite remember how he had gotten to the operating room. He could remember right before they set off. He could remember Bones settling him into the transport bed and squeezing his hand, he could even remember their conversation, no… argument:

* * *

“Jim you idiot! This is not a debate!”

“Leonard! Calm down. At least _listen_ to James.” Mrs. McCoy's reprimand was strangely comforting to Jim.

“I’m telling you Bones! I’m not going under again! I’m done with the fucking drugs! They don’t even help…”

_Why did he have to feel like crying?_

“Jim, you don’t understand, this is gonna be bad, kid.” McCoy didn’t want to scare Jim but his expression did nonetheless.

“Everything is always fucking bad! But I can handle it! I just _can’t_ handle being knocked out anymore. I can’t handle more of the dreams, I’d rather be in pain than that shit.”

“Jim… I know the others were bad, that the blood therapy is bad in general, but your body is weaker now and it's likely that Khan’s blood is going to induce an even stronger reaction than before.”

McCoy was beginning to doubt his decision of keeping the tumors from Jim. Jim would be furious when he found out, but maybe it would knock some sense into him. He couldn’t seem to impress the weight of the situation onto the kid. He didn’t want to lie to Jim but he didn’t need anything else to worry about, the blood therapy was going to be scary and painful, he just wanted Jim to trust his professional judgement.

“Listen Jim, I know this is scary, I know you hate the sedation, but believe me, you’re gonna want it, this time shouldn’t be the first therapy you experience awake. You don’t need to make this harder on yourself than it has to be.”

Jim’s hands, clenched into weak fists, were shaking in anger. The fists were a vain attempt to fight the tears but it was no use now; the tears were coming, and with them another wave of coughing.

_Damn, just when I could breathe again..._

Thankfully, Mrs. McCoy took pity on him, rubbing his arm while turning up the diffuser until Jim could catch his breath.

“Is this really what you want James? Even though you know it's going to be hard and painful?” She looked him in the eyes, asking him like his opinion mattered.

Jim nodded ‘yes’ emphatically, choking a bit on his words but resolutely pushing on,

“Anything is better than being out. Anyway, how bad could it be?” His grim, tight-lipped, smile didn’t hide any of Jim’s fear but it let a little of his personality shine through. 

Jim was always the stochic afterall, McCoy should have foreseen this much earlier, but by god why did it have to be this time?

Jim had agreed to be fully unconscious for all his previous Khan infusions, not that he had any choice, in those days whatever McCoy said happened. Jim was always either passed out already or in too much pain to protest.

As his mental state improved, Jim protested his pain regiment more and more. McCoy knew that it made Jim feel weak and helpless and emasculated but this really wasn’t the time for an ego crisis. 

Nevertheless, McCoy and Jim would constantly fight over medication, generally compromising on Jim being awake for the deep muscle, regenerative injections and some of the other regenerative therapies and being put to sleep for the blood transfusions and other, more invasive, tests. Even with this agreement Jim always fought in the last few minutes before being put under. Watching the fear in his eyes as he went to sleep was almost like losing him all over again.

McCoy didn’t want to do this, any of this to Jim, but he had his reasons. Even the most diluted versions of Khan’s blood therapy induced massive immune and nervous system responses. Jim’s body was viciously fighting the foreign blood as it was healing him and stimulating his tattered nervous system. This meant seizures, rashes, and possibly anaphylaxis as a start. The process was unpredictable at best and usually involved the strongest drugs they were willing to use.

The only reason McCoy agreed was a slow realization that Jim’s fight for independence, as frustrating as it was, was his way of fighting for his life. A life without choice was not one Jim was willing to have. McCoy wondered how many more procedures he would endure without a concession to his pleas to autonomy. The kid would be undergoing surgery with full anesthetic in the next day anyway, whether he wanted it or not, so giving him his freedom during the therapy, while risky, gave Jim some sense control over his recovery. McCoy would be a fool to deny this when he had the chance to involve Jim in the process and nudge him towards saving his own life.

  
  


* * *

Finally, after many moments of frantic searching, a face swam in to view.

Mrs. McCoy looked lovingly over the fragile man on the operating table before her. Once Jim spotted her above him, he instantly began to relax.

Many years as a nurse had prepared her for moments of pain and high pressure, but this was the first time she had been required to witness one of her own on the table. It wasn’t fear that was bubbling up in her, no, it felt much more like sadness, sadness for James and sadness for her son.

“Hi darlin’ how you holdin’ up?” She gently stroked his hair with her gloved hand, enjoying the more peaceful look on his face.

“I’m good… t’anks for comin’.” Jim croaked tiredly.

Now that he knew Mrs. McCoy was there he could finally close his eyes and shield himself from the blinding light of the room.

“We’re just about ready to get started darlin’. I’ll be up here with you the whole time, I’m not going anywhere.”

The ragged sigh of relief was so much better than crying, but Jim wanted to cry anyway. He had felt so scared here and suddenly Mrs. McCoy, like an angel, had swept in and saved him from everything- more or less. He didn’t want to be a damsel in distress but dammit, that's what he was and honestly it was just so fucking good to have someone care about him, someone who’s job didn’t depend on it, someone who wasn’t sleeping with him, someone who didn’t _have_ to care.

Mrs. McCoy understood the meaning behind the sigh and simply continued to stroke James’ hair, waiting patiently for her son to finish the preparations so they could begin what was bound to be a miserable therapy session.

Jim was still flat on his back, with the hope that it would encourage his airway to stay partially usable; the inadvertent side effect was that the world was beginning to seem very large and scary and much too far away from Jim. Everyone above him was a dark silhouette against the light. Only Mrs. McCoy, sitting beside him, was truly visible.

Bones approached and bent down to eye level with Jim,

“We’re about ready, Jimbo,” His smile was friendly and his tone was light but his eyes were visibly strained and scared.

“You’ve never been awake for this one so let me explain, luckily it's not like the deep muscle injections so no big needles, but we are going to put one other IV in your arm so your central line will be free for the therapy.

Jim could already feel his left arm being strapped down to an arm rest perpendicular to the bed and Ali preparing for the poke. Normally he would have struggled but with Mrs. McCoy’s continued comfort and Bones’ hand now rested on his chest, he was able to keep still and calm.

“We are willing to keep you conscious until you pass out yourself or your airway begins to close, at which point you will be intubated and sedated for the rest of the therapy AND you will be sedated for the next one as well, understand?”

Bones’ tone and the reality of his decision was beginning to make Jim scared. It must have been obvious because Bones gave him a pitying look and added,

“You can tap out any time and we’ll put your under but it will be an added delay to the therapy so I am going to ask you again, are you sure you want to stay awake for this, Jim?”

Gathering up his remaining courage Jim squeezed his eyes shut and murmured,

“Yes. I’m sure.”

Bones shook his head,

“Well don’t say I didn’t warn ya kid.”

Jim couldn’t see the look Mrs. McCoy shot Bones, but the subsequent huff made him smile.

“Let's get this show on the road.” Bones announced to the room at large.

* * *

  
  


“Ok Jimmy, the first thing we’re gonna do is push a real strong antihistamine into your IV, this is gonna make you a lil sleepy but it will help with immune reactions down the line.” 

McCoy put his firm hand over Jim’s as Ali pushed the syringe into the IV on his arm. 

It only took moments for the signs of drowsiness in Jim to become apparent; his eyes, although already shut, stilled, and his breathing became calmer. He wasn’t asleep, but at least for now he could rest.

“Now that you’re feelin’ all sleepy, we are going to begin the blood infusions. As I explained earlier we will do three infusions, this first one will be very weak and they will progress in strength from then on. You’ll probably notice the taste first and then by the second transfusion you’ll start getting some of the reactions; we are expecting some stomach pain, burning in your arms and legs, and some pain in your lungs.”

McCoy failed to mention the likely possibility of seizures. God, keeping Jim awake was dumb.

Through his drowsiness, Jim scrunched his face into an annoyed and pained expression. Knowing Jim, he didn’t want to hear about all this, he just wanted to get it over with.

“Alright, alright. I’m connecting the first infusion, you’ll be on this one for about two hours. I’m gonna need you to tell me exactly how you’re feeling through this and if you start to notice tightness in your chest or an increased inability to breathe. If I'm not right here you need to tell Momma right away. Jim! You hear?!”

Jim nodded tiredly without opening his eyes.

McCoy still wasn’t sure if the kid really understood what was going on. He had explained the whole thing in the hospital room before Jim was transported down to the operating room, but Jim had been upset and his attention span wasn’t good these days. He had even fallen asleep on the way down to the OR.

Carefully, McCoy starilied the central line again under the bioarch as a nurse brought over the transfusion bags filled with the precious, lifesaving poison.

Because the line went directly into Jim’s heart, the highest level of sterile procedure had to be utilized to prevent infection. As far as humanity had come medically, a central line infection was still incredibly dangerous and more treatment resistant than ever. Placing one had been a terrible risk but it was essential to saving Jim’s life.

Connecting the transfusion bag to Jim’s line carefully, McCoy turned on the pump and took a deep breath. It was started now, no going back. 

Jim looked serene as McCoy sat down on his other side, facing his Momma. He nervously began readjusting Jim’s IV and the straps on his arm.

“Leonard… leave the poor child be. Everything is going to be alright. James is going to be fine, he's tough.”

“You don’t get it, Momma.” The stress of all of this was putting McCoy into a bad mood. Typical.

“I don’t think he can do this. The therapy won't even be the most risky part. Besides, his pain tolerance isn’t what it used to be, he’s getting tired.”

“Hey… I heard that!” Jim said through his stupor. 

“You’re gonna ruin my reputation!” He sounded groggy but the corners of his mouth were turned up in a mischievous smile.

“Shut up, you pompous brat.” McCoy smiled fondly at his patient. 

He missed these days, he desperately wanted to just be annoyed with Jim instead of constantly scared for him.

“Never.” Jim whispered.

His smile turned to a look of disgust as a wave of nausea and the sickly-sweet, metallic taste of Khan’s blood filled his mouth. It was thick and strangling and streaked with the taste of iron and lead. It tasted like hate.

Sticking his tongue out and coughing, it was clear the infusion was beginning to take effect.

“Ok kiddo, I’m gonna need you to take some deep breaths. Momma is gonna be right here with the bucket in case you need to vomit.”

“Bo...ones… Water?” Jim was coughing and retching, trying to get the horrible taste from his mouth.

“Dammit… Ok, but only a couple VERY small sips.” This wasn’t going to end well.

Gently lifting his head, McCoy placed the straw in Jim’s mouth. Jim was only able to take two small sips before throwing them back up onto McCoy and himself.

“Shit! I’m sorry!” Jim’s eyes were open and scared.

“Shhh Jimmy, it's ok, don’t you worry.”

What was wrong with the kid? He looked so scared.

Mrs. McCoy gently cleaned Jim up while McCoy found some mint lozenges that would hopefully mitigate the taste. It was a side effect that Jim would be dealing with for the next week or so but surely during the infusion it must be overwhelming. 

The vomiting seemed to spark a wave of panicked breathing accompanied by stomach spasms the likes of which Mrs. McCoy had never seen before.

“Leonard! Something’s going on with James!”

McCoy rushed over frantically, taking one look at the spasms and the hyperventilating and jumped into action.

“I’m going to give you a couple hypos now, just hold on, Jim.”

The first was directly into the abdomen, set on the deepest possible range with the hopes of targeting the internal muscles directly. If the hypo didn’t work, they would have to resort to a needle next. 

Jim hissed through clenched teeth as the second hypo filled with a relaxant went into his neck.

McCoy knew how much Jim hated hypos and how much of a blessing the central line was because of this, but nothing was faster than a hypo and the tray full of them against the wall would surely be empty by the end of the therapy.

Tears were running down Jim’s face now, teeth clenched, and breath stifled. He wasn’t just in pain, the kid was panicking. This was not the time, the damage to his lungs and stomach were already extensive, why did he insist on being awake?

“I’m sorry Bones” Jim gasped through his panicked breaths.

“I’m really sorry.”

* * *

  
  


All the grogginess had left Jim now.

He desperately wished that pain was all he was experiencing as the full weight of his panic attack crushed him.

It had been a very long time since he had thrown up on someone. In front of people? Sure, frequently now. But actually on them? It brought back vivid memories.

On the ship back from Tarsus IV the medical crew had attempted desperately to save the starving children aboard. Unfortunately, the majority of medical personnel on that particular ship had been volunteers, uninformed and largely unsupervised. They had begun to refeed the emaciated children immediately, pumping them as full of liquid and solid nutrition as possible. Jim had thrown up so much precious food in those first few weeks… the children’s starving bodies couldn’t handle the sudden influx of food and if the famine didn’t kill them all, the crew’s ignorance took more.

It had been devastating to throw up so much food after having so little, for so long. Jim couldn’t help but be haunted by the memories of children who didn’t make it off the planet every time his stomach rejected the food. The medics had been ridged about feeding, especially early on, using force when needed, and getting angry at Jim’s vomiting, scolding him for wasting food while trying to get him to consume more. Punishing him when he threw up on them, even when he couldn’t help it.

It had been a miserable trip, an almost life-ending one. Jim still couldn’t taste bile without fear coursing through him and without guilt overwhelming him. Even though he knew it was his most trusted friend who he had thrown up on, the fear of the slimest possibility of looking up to see him angry was almost too much to take.

The pain in Jim’s stomach was beginning to overtake the panic in his chest. The stabbing pain of whatever Bones had shot into his stomach was excruciating but it slowly began to relax his convulsing muscles, allowing Jim to breath again, but after that the pain never quite dissipated completely.

  
  


* * *

The rest of the first session passed without much more commotion.

Ali noted and allerted the others to an increase in Jim’s body temperature and white blood cell count as his body prepared to fight the infusion; however, at this point it wasn’t severe enough to warrant intervention or concern, it was simply an indication of what was to come.

People cycled in and out but Jim was oblivious to all that. 

He could feel the touch of nurses placing ice packs on him, and respiratory therapists scanning his airways but, for once, the touch meant nothing to him.

As long as he still had Mrs. McCoy’s hand in his and as long as he could hear Bones nearby, Jim was sure he could tolerate anything.

It wasn’t that the pain was overwhelming yet, especially with all he had been dealing with, but his muscles were certainly beginning to suffer.

The second round began with little fanfare, only the infusion team’s quiet bustling about. It seemed like all of them were whispering, giving Jim the most peace possible. The small corner of his brain that could still register such things was grateful as his head was beginning to pound loudly.

The second session came on much more swiftly, and unpleasantly than the first. Jim’s expression made it obvious to McCoy that his patient was beginning to suffer.

“Hey Jimbo, you’re doing so well kiddo, I’m real proud. I can see you’re pretty uncomfortable and that the muscle spasms are back so you’ll be getting another round of hypos but Ali and I will be quick and I promise it will be worth it.”

Jim scowled but did not protest as the doctors began, first injecting the relaxant and anti-inflammatories into his legs, progressing to his abdomen and arms, and finishing with another in his already sore neck. 

Jim gritted his teeth and bore it all in silence. 

The muscle relaxers did their job but could not stem the burning pain spreading through every nerve in Jim’s body. Wave upon wave of searing pain would rage though his body as Khans blood stimulated the nerves while they fought back.

It was eye watering pain, even Jim’s face, eyes, and soles of his feet felt like they were melting off, his lungs felt like they were filled with fire, choking him.

“Bones! I can’t breathe!” Jim shook his head frantically gasping for air.

“.....lungs on fire!”

“Shit kid, give me a second”

The shrill warnings from the biobed kept time with the shocks of pain running through him, paralyzing. 

Another hypo of pain meds and some more steroids for the inflammation, oxygen pumped up and supplemented with steroids as well. McCoy would do anything that could be done to help the kid keep going.

McCoy didn’t like having Jim awake but he wasn’t gonna put him under unless he had to, he would respect Jim’s decision until the last second.

“Are you done with this kiddo?”

Still violently gasping and coughing, Jim clearly shook his head ‘no’.

“Ok… well once the steroids kick in we are gonna start session three, let me know when you’ve had enough.”

Jim nodded in acknowledgement and screwed his eyes up trying to breath through the blinding pain.

The blessed meds did their job in time and Jim was able to breathe again in a matter of minutes but his breath was raspy now, uneven, shallow, and painful. 

He wasn’t ready for more pain. The agony of his nerves being electrocuted by Khan’s blood had only slightly diminished with the pain medication. This was the type of pain with no real solution, no end. 

He wasn’t ready but he had to push on, had to get through this last round. He mustered all the strength left in him and told Bones he was ready to start again. Bones looked doubtful but nodded to the others to connect the last, and strongest bag.

“Ok Jimmy, this last one is the shortest but it's gonna be an intense one. You’re probably gonna feel like puking for most of it so we’re gonna turn you on your side and give you another hypo for the nausea. Momma will be right here if you need anything.” 

Jim just nodded weakly, surrendering completely. He wanted this to be over so bad. The pain was overtaking every fiber of his body and it took all his power just to keep breathing. Moving himself was out of the question and even the hands turning him onto his side felt as though they were burning him.

He coughed and choked over the pain, it was as if someone was punching him constantly in every inch of his body, but especially his stomach. He couldn’t seem to catch a break, the muscles clenched and wave after wave of nausea caused him to retch and vomit nothingness as soon as he was on his side. 

Mrs. McCoy’s cool hand was on his forehead now as she whispered gentle words of encouragement. He couldn’t really see or hear or feel anything through the pain, all he knew was the cooler spot on his hot face and that someone was there and talking to him.

His breath was ragged as his throat felt like an increasingly tight tube of sandpaper. The muscle contractions were becoming stronger again and his skin was hot and red and swollen from the immune reaction. Everything was screaming even if Jim couldn’t. He barely felt or heard the next round of hypos but they made little difference. All he could do was lay there and wait and try not to pass out. This was miserable.

Everything seemed to be pulsing now. His pulse was raging through his head, pounding on the inside of his skull, he could almost feel Khan’s blood rushing through him with every deafening heartbeat. Jim shook his head trying to get away from the sound and the thumping through his body but all it did was make him retch again. 

Always the guardian, Mrs. McCoy was there with the bucket, even if he had nothing to throw up. 

“Shhh James, you’re doing amazing. You’re almost done. There’s a good child.”

She rubbed his shoulder and even through the pain of the touch, it somehow made him feel better.

The retching and the touch sent a cascade of tears down his face, both out of pain and emotion; Mrs. McCoy lovingly wiped them all away.

“Oh James, don’t you worry, you’ll be just fine and things will get better, just let it all out.”

“I just want to be done!” It was a raspy, quiet, embarrassing cry.

Jim felt just about at his limit now, and the full weight of it all was crashing down, collapsing his world. This was so horrible, this was so humiliating, this was more than he could take. All of it.

“I just… I… Why can’t Bones just let me die, let me go?”

Mrs. McCoy did her best not to look shocked by this sudden wave of despair coming from the man before her.

“Oh child… Leonard cares about you too much to let that happen, we all do.”

“It's just his damn job…” Jim was really crying now.

“No James, it's not just his job, it's his whole life. You’re his brother now and as long as he's breathing, he will never let you go.”

“But what if I want to go?” Why was this coming out of the blue, wasn’t the physical pain enough?!

“I can’t take much more of this, Mrs. M…”

“Be strong James. We are all here behind you. You’re almost done. Don’t let your strength fail you now.” 

If his strength wasn’t failing him yet, his body was.

Mrs. McCoy stopped talking and just held his hand, letting him be for now, but keeping her concern close by, a mental reminder to discuss it with her son later.

Jim was swimming in and out of consciousness now. He had to stay awake, he just had too, but everything was becoming way too much. Stars danced behind his eyes, right flashes and colors making him sick, he tried opening his eyes to find an equally blinding atmosphere. It was all just too much. He couldn’t seem to grasp what was real as the world seemed to leave him behind as he was lost to the hallucinations and brightness.

“He’s seizing, let's push the last round of meds before this gets any worse!” 

It was expected, but watching Jim shake on the table was terrifying as always. Even when the drugs began to work and Jim came back to himself, he didn’t seem quiet there. He just needed some time, needed a break.

  
  


“Ok Jimmy, we’re done with the last infusion. We are gonna give you a while to recover while we run fluids and TPN through your line, but things should be getting better from here. I’m gonna give you some more pain meds anyway, just try to relax.”

The hypo must have been filled with heaven, or maybe it was just the relief of being finished. He had held on through the therapy and now he could finally let go. Jim slipped peacefully into a comfortable unconsciousness. Maybe his mind would give him a break, just for once, and let him sleep.

McCoy certainly hoped so.


	12. Uncertainty of Emotion

**Summary for the Chapter:**

> Spock arrives in Atlanta to help care for Jim.   
> It's only a matter of time before he starts annoying McCoy and over exciting Jim.

**Notes for the Chapter:**

> I'm sorry guys, I don't really have an excuse for taking so long to update. The world has just been crazy, you know?
> 
> I think I might be losing a little bit of my focus with this story. Is it still making sense? It's one of those times when you say a word over and over again until it loses meaning. It's hard to get prospective when you're so far into the writing.
> 
> Stay safe everyone! Wash your hand for Bones!

Jim rose back into consciousness slowly, feeling his body first, its intense sensations drowning out everything else. His nerves sizzled and the throbbing in his lungs was more intense than ever, radiating through the surrounding muscle. This was the stage of the blood therapy that Jim had grown familiar with; he could now look forward to a week of vomiting nothing, blinding headaches, and the taste of poison still coursing through his veins. It would be miserable, and yet, as Jim warmed to his surroundings, he didn’t exactly feel dread, he just felt thirsty. 

Drops of sweat snaked down his neck as he weakly lifted his head, prying his eyes open to look around him. 

He was back in his own hospital room, made familiar by the fuzzy, blue blanket Mrs. McCoy had brought him, and an array of Bones’ personal items, cast aside in hurried carelessness. His room was a relief, it meant that Bones was nearby, it meant that the procedure was over, and that he was safe; but, in the midst of the familiarity, something was different…

“Hello, Captain.” 

The voice was steady and formal and immediately recognizable.

“Spock!” 

Jim tried to push himself up to sit at the realization of his First Officers’ presence.

“Now Captain, I’m under strict orders by the Doctors not to over excite you.”

Spock approached the bed so to stay in Jim’s line of sight without encouraging him to sit up any further. 

Still at a safe distance, he observed the ill Captain. 

It had been mere weeks since Captain and Doctor had left San Francisco but the man before him looked much different. Jim had gotten skinnier in his absence and his breathing was visibly labored, but his eyes were clearer now, still foggy with sleep but lacking the drugged-shade they had during the first weeks of his recovery. It was hard to look at the man and not think of his former glory, not reflect on how quickly health could be taken from one, not remember the strength and confidence and smile that had been so rapidly replaced by skin and bones.

Staring at his profoundly changed friend, Spock couldn’t help but reflect on his own appearance as well. Even in his immaculate uniform, he still felt disheveled and careworn. In reality, the only signs of fatigue were the dark circles under his eyes and his now thin and pale-green face; the mental wear had been much more severe. The aftermath of the disaster was trying on the entire surviving crew, and Spock’s responsibility as the highest ranking, fit officer weighed heavily on him. The worries for his crew were only eclipsed by the continual, painful debriefings by the admiralty that were quickly becoming hostile interrogations. He barely had time to meditate, let alone eat or sleep. When given the opportunity to care for Jim in Dr. McCoy’s hours of absence, Spock had jumped on the possibility of sleep and food as well as time spent with Jim, and hopefully, occasionally alone.

As Spock surveyed him carefully, Jim’s skin crawled, he hated the feeling of being examined and watched. Spock always did it, but since Jim had been subjected to the same scrutiny day after day here, his patience was diminishing. 

“Hey Spock! Quit gawking at me! Give me an update! I want to know what's been going on! They treat me like a child here!” 

_ Boy was he awake now! _

Spock deliberately paused, considering what to say. Along with a stern warning not to over excite the Captain, Dr. McCoy had also been very clear that Jim was to know the bare minimum. The Captain was supposed to be resting and healing and any derivation from these goals would be grounds for expulsion from the hospital, no matter the rank of the person in question. Spock didn’t doubt the seriousness of the Doctor, but he did know Jim well enough to recognize how torturous isolation must be for him. 

After a moment of consideration Spock opened his mouth slowly,

“Captain, I have been instructed to avoid the more… serious topics for the moment. However, I think it would not do too much harm to give you a short update, -”

McCoy swept in as if on cue. Filled with fury and purpose, he strode right up to Spock, putting himself between Jim and the Vulcan. Spock stepped back as McCoy pointed an accusatory finger in his face.

“Dammit Spock! What did I tell you! Jim needs rest, he doesn’t need to be bothered with that nasty stuff now! I thought you damn Vulcans followed the rules!”

Spock had the common sense to look vaguely regretful. 

“My apologies, Doctor. I was simply attempting to put the Captain’s mind at ease.”

“Like hell you were!” McCoy scoffed.

“You said you would come and be  _ useful _ not put a new set of worries in Jim’s mind.” 

Admittedly McCoy was enjoying this opportunity to finally rage at someone again; sensing the growing rage, and feeling some of his own coming on, Jim weakly cleared his throat, just loud enough for Spock and the red-faced Bones to look at him,

“You know I’m here, right?” Both men looked ashamed at his weak, but resolute, words.

Trying to sit up once again, Jim was caught by a round of coughing that shook his body and made his head spin; trying to prove his independence, he waved off Bones’ approach and finally pushed himself up to look at them. It was impossible to miss the look on Spock’s face, the now familiar  _ ‘god, he looks worse than I thought’  _ look but Jim did his best to ignore it.

“I might be sick, you idiots, but I’m not dumb! I have a right to know what's going on with me and I have a right to know what's happening to everyone else! You haven’t even let me see the news since I first woke up!” 

His anger startled himself as much as anyone else. Jim hadn’t realized how much he had been pushing down, how much the pain and helplessness had crushed him, how angry he was at everyone, and everything, at himself. And now that he had started it seemed the anger only kept building.

“I’m alone here all the time! Its only these fucking doctors coming in to pump me full of drugs and poke me. Even  _ you  _ Bones, you’re just another damn doctor now.”

The look of shock and hurt on Bones’ face made a cold part of Jim satisfied, but the rest of him registered Bones’ pain and Spock’s alarm and begged himself to stop; but now he couldn’t, it was just too damn much.

“None of you understand!”

The anger was really overwhelming him now, tears were welling him despite his best efforts, and his breathing was becoming panicked and shallow. Through the desperate gasps for air Jim valiantly continued to speak,

“I’m-not-even-a-person-any-more-”

It was a lost cause now. The breathlessness was overtaking him, his lungs felt as though they were filling with cement, he simply could not seem to breathe. 

Darkness was beginning to creep into the periphery of his vision as he still glowered up at the men above him. He couldn’t talk now, but that didn’t stem the anger. 

As the blackness consumed his him completely Jim thought, 

_ If I die now, it serves them right _

But he didn’t really believe it, the darkness was sad, not angry.

  
  
  


“Doctor…?”

Neither man knew what to say to one another as McCoy rushed to replace Jim’s nasal cannula with a pressure oxygen mask.

Turning on the Vulcan suddenly, McCoy spit out,

“Dammit Spock! He’s  _ fragile _ ! He’s having another surgery tomorrow, the last thing he needs to think about is the outside world. It won't matter if he can’t pull through!”

After a long moment of silence Spock replied, looking down at their Captain,

“Doctor, as much as I respect your professional opinion,” 

McCoys scoffed under his breath,

“I believe the Captain has a right to know what has been happening. It's been long enough. You say that he is awake more, all the fuss at StarFleet, the funerals… he’ll find out about it all sooner or later.” 

Looking back up at McCoy solemnly,

“Have you even told Jim about his surgery, Doctor?”    
  


The eye contact was making McCoy uncomfortable, dammit he hated these emotionless bastards.

“Well I was going to fucking tell him but then you had to come rile him up!”

It was a half truth, McCoy had been putting off telling Jim, putting off  _ deciding  _ whether to tell Jim. Was it his professional concern for his patient’s mental health that was making him withhold so much, or was McCoy becoming painweary, hoping to save Jim, and himself, from more fear and agony?

Rubbing is eyes, feeling the fatigue and defeat crushing him, McCoy said,

“Listen Spock, I don’t know what to tell ya, Jim’s been through hell, I can’t say he’s even getting much better. We just have so far to go and I don’t want to distract him from his fight.”

Looking down at Jim, sadly, lovingly, he continued,

“I want to take him home so bad, Spock. If we can get him through this surgery, and through this week I think we can make it. But I can’t have anyone fuck this up! I can’t be here all the time and I need someone, I need  _ you,  _ to protect him. Ya understand? That means not burdening him any more than necessary! Muster up as much hope as your Vulcan heart can and help me get Jim through this.  _ Please…” _

The doctor’s resolute facade fultured for a moment as fear and sadness almost overtook him,

“I understand, Doctor.” Spock didn’t know what else to say, this was not the belligerent doctor he knew.

“I have to go Spock… I’ll be here first thing for the surgery. Please be careful with Jim. Tell him about the surgery if you want, but don’t burden him with anything more than he can take.”

“Yes, Doctor.”

McCoy shook his head tiredly, taking one last look at Jim before reluctantly leaving the room.

  
  
  


The bio-bed gave a soft indication of Jim waking up, startling Spock out of his quiet reflection.

The blue eyes fluttered open and a moment of peace and understanding hung briefly in the air.

“Captain- about last night…”

“Eh, can it Spock, I’m used to this shit by now.” 

Jim felt bone-tired, tired of himself and everyone else.

“Can you just tell me what happened and what's going on?” He tried his best not to sound scared, but he was, and it rang loudly in his croaky voice.

“Jim… I believe the argument between Dr. McCoy and myself may have… upset you and caused some sort of panic response which led to your blacking out.”

Jim’s cheeks flushed at this, as he squeezed his eyes shut.  _ Dammit, why do I have to embarrass myself in front of nearly everyone? I should be stronger than this by now! _

“After reflection I realize I should have followed the doctor’s instructions more precisely,”

Jim looked angry and ready to emphatically protest,

“ _ however…”  _ Spock carried on, ignoring Jim,

“I recognize your need for information in order to feel sane in this scenario; while Dr. McCoy is still very reluctant, he has given me limited permission to inform you of the bare minimum need-to-know during his absence.”

“Really?!”

Jim’s heart-rate peaked in anticipation and he tried to sit up fruitlessly. He attempted to conceal his resulting coughing, obvious though it was.

Giving a disapproving stare, Spock raised the bed for Jim and sat down beside the man. 

“Doctor McCoy told me to inform you that your coughing is a result of some possible tumors in your lungs, as soon as the doctor arrives you’ll be prepped for surgery. They say that it will be relatively simple and should make you feel much better soon. I’ve been told that we can look forward to your release from the hospital presently.”

The range of emotions playing on Jim’s face both confused and fascinated Spock. 

“Oh.” 

Barely noticeable, Jim squeezed his hands into shaking fists.

“What if I don’t want the surgery?”

Stunned silence blanketed the room, as Spock searched for some ounce of logic to grab a hold of.

“Jim…?”


	13. Surgery Part 1

**Summary for the Chapter:**

> Jim needs surgery, now, but he has his doubts.  
> He's had enough pain for a lightime, and his willingness to take more is waning.  
> McCoy however, will never sit back and let his friend die, no matter the price.

**Notes for the Chapter:**

> Hi guys! I hope you are all healthy and handling isolation ok!  
> I am an essential worker and so everything has been pretty hectic but I am happy to announce that I have another chapter coming right after this, probably within a day or two.
> 
> Stay safe guys! Love you!

Entering the room just as the sun’s rays began to make their way through the hospital, McCoy mustered up his remaining energy, pretending that he hadn’t spent most of the night reviewing Jim’s charts and planning each and every move of the upcoming surgery. He was sleep deprived all right, but that happened to be his specialty.

Jim’s room contrasted painfully with the warm, Georgian air outside. Icy silence permeated every inch, choking out the warm, morning light from the windows.

Spock was standing over Jim’s bed looking more grim and tight-lipped than ever, and Jim, Jim clearly wasn’t asleep, but his eyes were closed and tear marks were visible on his flushed face.

McCoy paused for a moment, puzzled, he had evidently walked into something he didn’t understand. He resisted the urge to run to Jim, to interrogate him and find out what was wrong, instead, he shot a quizzical, if somewhat accusatory, look at Spock.

“May I speak to you? - in private, Doctor?”

Spock was really starting to worry McCoy now, the angry look on Jim’s face didn’t help either.

Once out of the room McCoy couldn’t restrain himself,

“What the fuck is going on here, Spock?!” 

The Vulcan didn’t react to the outburst but calmly explained,

“I am concerned regarding the Captain, Doctor. I just informed him of his surgery - we didn’t discuss anything else;” Spock answered McCoy’s unspoken question without being prompted.

“however, his reaction disturbed me. He says he does not want the surgery… he says he is ‘tired of being poked and prodded and hurt.’ He does not want to tell you, he feels... ashamed, but he says he would rather die than keep enduring these procedures.”

McCoy felt as if a baseball bat had suddenly made contact with his skull. The shock, _ maybe it shouldn’t be shock?  _ was visceral and physically painful.

“I… He can’t! He has to have the surgery! No question!”

“Doctor-”

“NO Spock! We have come too far now, he is having the surgery whether he likes it or not.”

McCoy couldn’t think, he could barely breathe. The words came from him without thought or hesitation, but he meant them wholeheartedly. He couldn’t  _ and wouldn’t  _ allow Jim to give up his fight.

“I think you may be overreacting Doctor… Jim’s fatigue is understandable. While it is logical for him to continue with his treatments, I think we can all agree that they have caused him a significant amount of suffering.”

“You think I give a damn about ‘overreacting’? Spock, he wants to give up!”

McCoy didn’t quite know where all the anger was coming from. He wanted to rush into Jim’s room and shake the kid until he saw reason. But McCoy hadn’t even talked to him about it, never told him about his situation. Jim deserved to be upset and scared. That was his fault, not Jim’s, not even Spock’s. 

McCoy tried to shake the anger still lingering in his body before straightening up and facing Spock,

“I think I need to go in and talk to Jim, I think I may have fucked up.”

Spock nodded his acknowledgment, seeing that there was no more he could say except,

“In that case I will take my leave now, Doctor, please keep me apprised of the developing situation.”

“Will do, Spock.”

Spock left him in the hallway where McCoy gathered his courage, pushed down his fear and anger, and entered Jim’s room.

This would have to be a careful dance, not unlike the ones they had done a thousand times before. Their roles were unfortunately familiar: Jim didn’t want to hear that he was injured or something was wrong, and McCoy wouldn’t let him escape the truth. If only the situation wasn’t so dire. It felt wrong keeping the mood light at a time like this, but McCoy wasn’t sure Jim could take it any other way.

“Jim, how ya doin’ today, kid?” 

The icey atmosphere hadn’t left the room despite McCoy’s nonchalant, almost bright, demeanor.

“Cut the bullshit, Bones, I know Spock told you everything but I’ll tell you again,” Jim coughed violently, somewhat undercutting his point,

“I am NOT having the surgery. I’m done Bones. I mean it.”

McCoy braced himself, trying to look unruffled. It was so hard to remember how to be himself, the version of himself from before, one that took no shit from Jim. the one whose heart didn’t break when Jim spoke. 

Not only was the kid killing him, he was turning him into a sap.

“Look Jim, quit being an idiot,” 

_ Ah, there’s some of that old attitude. It feels much better. _

“You need this procedure, and you need it now. But before we get into that, I need to say something...” 

McCoy took a deep breath. He wasn’t exactly used to admitting he was wrong.

“I fucked up Jim, I should have explained this first, I should have involved you in the decision. I know you’ve been in the dark and it's killin’ ya. I’ve been trying to give you room to heal, but I might have gave you too much. I’m… sorry.”

It was hard to read the look on Jim’s boney face. It looked something like shock. Maybe he was still mad? McCoy noted his fists unclenching, however, and the imperceptible hints of Jim leaving his fight-or-flight mode. 

“Bones…” Jim was torn between his anger and Bones’ pleading eyes.

“You just don’t understand Bones… you just don’t!” He wasn’t angry, he  _ couldn’t  _ be angry at Bones, but he was upset, he was so, so fucking upset.

Thankfully, Bones sat there, next to his bed, looking at Jim, instead of the monitors, listening to him.

“I don’t think I can take this anymore. Bones’, I’m not getting any better, so what's the point? Is another surgery going to make any difference in the long run? Really? Honestly Bones,  _ honestly _ , am I going to survive this?”

It was impossible to know what to say. Years of that question from countless patients didn’t prepare McCoy to answer his friend.

“I can’t say anything for sure, Jim, but I can tell you that without this surgery, your quality of life will only get worse. Let me explain, and then we can decide. I promise, I won’t leave you out this time.

“You see, the radiation has been causing damaged cells to replicate very quickly; while Khan’s blood has helped your body repair itself, it has also given some of these cells a boost. They have been rapidly creating tumors in your lungs, your lungs which are already badly damaged. The tumors have decreased your lungs functionality which has allowed some radiation induced pneumonitis to develop. That's why you’ve been coughing, and it will cause the parts of your lungs, not damaged by the tumors, to fill with fluid. Jim, if we don’t act now, we can’t prevent that fluid build up, you’ll drown here, in your bed.”

Jim looked scared. It was the very thing McCoy had hoped to avoid, but maybe it would help Jim fight for his life.

“The surgery is our last hope of removing the tumors and inserting drains in the lungs to get some of the fluid out. Removing the tumors will hopefully prevent them from becoming malignant, and can buy us some more time for the respiratory drug therapies to start working.”

Jim couldn’t look at Bones, he felt stupid for upsetting him, but he had to make Bones see why, dispite all of this, he didn’t want the surgery.

“Jim… I know it's scary, I know it's all been far too much, but we are  _ so close _ to getting you out of here. I just need you to fight a little bit longer and then you’ll be in my Momma’s house and things will be alright.”

Jim really did want to believe him, he wanted to believe that the pain in his lungs, the pain  _ everywhere _ , would go away with treatment, he wanted to believe so, so hard, but that just wasn’t enough.

There didn’t seem to be any point anymore. It was just trading one wound for another. He was just so sick of living on stolen time, he was just so sick.

“Bones, it never fucking ends! You can’t tell me this will be the last procedure or that I’ll be getting better soon, you can’t. We don’t know if it will even help, I don’t want to keep doing all of this for nothing, I don’t…”

“For NOTHING?” McCoy couldn’t help himself,

“Jim, you dumb kid! This isn’t for nothing, this is your  _ life  _ we’re talking about. Do you really think I’ve been busting my ass for weeks for NOTHING?!” 

McCoy was angry. He was angry at himself for not seeing this coming, for treating Jim like an object for so long that he had forgotten how to feel like a person;  _ and  _ Jim, he was suddenly furious at the man who never gave up, who cheated death at every turn, who was the embodiment of beating the odds, who now wanted to let all that life go to waste…

The anger clogged McCoys throat until he was gasping for air, unable to speak through the tangles of his fear and rage.

“Woah there, Bones,” Jim’s voice was worryingly raspy and filled with apprehension, rather than the previous anger.

“I’m… sorry” he did sound sorry, but there was no indication of a change in heart.

“Sorry be damned, Jim! You listen here! You’re one hard son-of-a-bitch to kill, and I won’t be the one to let you die, not on my watch! God knows I’ve saved your life more times than I can count and I won't let you ruin my streak,  _ and”  _ McCoy raised his hand to stop Jim from interrupting his tirade,

“and, more than that, you’ve fought too hard to quit now, Jim. You owe it to yourself to keep fighting, just a bit longer, I promise. We can get you through this if you let us, but don’t let your life go to waste, not after all you’ve survived.”

As arrogant as the bastard could be, Jim wasn’t really one to make these things about himself, so McCoy was surprised when the resolute look on the kid’s face began to fade and genuine fear replaced it.

Suddenly Jim, who always had something to say, had no words. It was undeniable that he had escaped death more times than any man should, but over the years he had taken that to mean that he was meant to die and he couldn’t cheat it forever. His survival was never a triumph, it was some kind of cruel joke. He should have died on Tarsus IV, he should have died on the Narada, at the attack on Starfleet HQ, side by side with Pike...

Jim choked up suddenly, the pain of thinking about Pike was overwhelming him, the pain of all those should-have-beens, overwhelming; the inescapable pain steadily worsened in his chest. It was impossible to know which was the cause, but Jim could no longer breathe.

It was the silence in the wake of his speech that first told McCoy there was something wrong, but the look of panic on Jim’s face truly shocked him into action. Jim was gasping and choking, with all the fear of a drowning person painted across his face.

When a person’s lungs begin to fill with fluid, in Jim’s case, as a product of radiation induced pneumonitis, they will literally begin to drown in their own bed. As it becomes impossible for them to breathe, they will reflexively begin to thrash about as if to escape the all encompassing feeling of drowning on dry land.

McCoy knew this, and yet, was still unprepared to see Jim deteriorate before his eyes. It was obvious to him that Jim’s respiratory distress was not simply caused by his pneumonitis, which he had expected, but Jim was also enduring pain of a mental variety, making the additional pain and struggling nearly unbearable.

Jim was thrashing around now, engulfed in his panic attack and confined by each, progressively more labored, breath. It was time for McCoy to make a decision, though there was no question in his mind. Jim would be saved, over and over again if need be, until McCoy could go no further; if he had to spend the rest of his life trying to keep this kid alive then god dammit, he would.

After pushing the respiratory alert on Jim’s biobed, McCoy reminded himself to stay calm,  _ like a fucking intern _ , Jim wasn’t dying yet, he could still breath as of this moment, and in the midst of the panic, Jim needed to be reminded that this fight was his own; McCoy couldn’t fuck this up again.

“Listen here, Jimbo, I know you're panicking and it's gettin’ pretty tricky to breathe. We need to start this surgery and we don’t have much time. I know you’ve had your doubts, Jimmy, but I need you to trust me, please. We can talk about this when you wake up, but for now I’ve got you darlin’ and everything is going to be ok…”

Jim’s eyes were open as McCoy cradled his head in his big, steady hands. He was fading a little but was present enough to shake his head violently as he saw the respiratory team rush into the room. 

“Hush now, Jimmy, it's gonna be ok. I promise I won't let anything happen to you, I wont do anything that I don’t absolutely have to, and I won’t leave you alone...”

Hands beginning to shake now, Jim grabbed the front of McCoy’s scrubs and breathlessly whispered,

“I’m scared Bones, I don’t want to die… I’m sorry…”

McCoy’s breath caught in his throat, almost choking him too, for all Jim’s stoicism, he was really, truely, scared. Scared to stay, and, maybe, more scared to be gone.

“Hey now,” McCoy squeezed Jim’s hand as he motioned for the team to approach

“I’ll be damned if I let your dumb ass die now.”

Jim's smile, between panting breaths, was genuine and gave McCoy some comfort as he administered the sedative handed to him.

With the respiratory team’s quick work and Ali preparing the OR below, Jim was ready for surgery in no time. McCoy was completely focused now, entering surgeon mode and leaving the rest of the world behind.

It was just Jim and himself now, the rest of the world be damned.


	14. Surgery Part 2

**Summary for the Chapter:**

> McCoy looks a Jim, he looks back at McCoy.   
> Maybe the hopeful side of Jim is still alive.

**Notes for the Chapter:**

> Hi guys!   
> Thank you so much for the comments on the last chapter, I am glad that this is a helpful distraction from all this craziness. It means so much that you're all enjoying it! I love you!!!  
> Big props to you essential workers out there and if you're stuck at home, thanks for doing your part!!!
> 
> Stay safe out there!

Pulling off his gloves and cap, McCoy finally took a breath of longed-for fresh air.

He hadn't been sure anything would be easy with Jim again, but the surgery, as complicated as it was, had gone relatively smoothly.

The amount of fluid in Jim’s lungs had been remarkable, it was a wonder the kid had been able to breathe for has long as he did; but, with the polar-osmosis respirator, they were able to drain the lungs of a significant amount of liquid and remove the many tumors hiding in the tissue. His lungs were pockmarked now, but the regeneration unit placed subdermally in his sternum should allow for a slow and steady regeneration that would increase Jim’s lung capacity over time without encouraging quick cell replication and reducing the risk of cancerous mutation. 

The work was done now, all that was left was to watch and wait for Jim to stabilize and wake up.

Awash in the recovery room’s bright, artificial light, Jim looked very, very pale. In the age of noninvasive medical technology, the various tubes winding in and out of the fragile body were enough to make even the most seasoned surgeon uneasy. McCoy had threaded every line, placed every drained, now collecting pink liquid from his newly cracked chest cavity, he knew every suture crisscrossing his friend’s chest, and he had grown accustomed to the sounds of the ventilator as it loudly pushed air in and out of Jim’s body, and yet, all of it together, under the unfamiliar lights of the recovery room, threatened to overwhelm McCoy in a wave of uncertainty and helplessness.

These measures to save Jim’s life, and all the pain and suffering they caused, were McCoy’s doing, but now after it all his friend's body looked like a foreign landscape, a landscape he was constantly at war with, a landscape that was looking more and more unfamiliar by the day.

For all the control he held over Jim’s life, listening to the machines keeping the kid alive, watching liquid fall from his poor bandaged chest…

McCoy was struck by how powerless he was now. All that was left was to see if this would work, more importantly to see if Jim’s body, subconsciously or not, would surrender to healing. 

It was undeniable that Jim was becoming stronger now, not necessarily physically, but he was definitely re-emerging mentally. His restlessness couldn’t stay buried forever, the clashing of wills had only just begun. 

McCoy had so many things to worry about before, he could barely acknowledge Jim’s impending struggle for independence, his body had been too weak before.

It had reared its head first in San Francisco, when it had become apparent that, when awake, Jim was denying treatment to save face, for god knows who; now, not only was Jim growing impatient and self conscious, he was also struggling with intense pain for no apparent payoff, he was struggling with his body begging him to give up, and struggling with the knowledge, perhaps still deep down, that even after the physical pain subsided, he wouldn’t be able to escape the memories, Pike, and StarFleet forever.

The knowledge of this hanging over McCoy’s head, gave light to some of the dread Jim must be experiencing. His mind and body were growing tired of fighting for a future filled with just as much helplessness and misery. McCoy didn’t have a light at the end of the tunnel to offer Jim, rather, Jim’s life was perhaps McCoy’s only light in the tunnel, maybe the only thing keeping him fighting. He wasn’t sure he could fight for both of them anymore, now that Jim was gaining the strength to resist.

The monitors had been steady for a while now, Jim’s breathing as deep as could be managed, and his stats acceptable. He was ready to be moved to his own room, and McCoy was ready to finally find some peace away from the eerie lights and his thoughts. He followed the transport team as if in a dream, maybe the sleep deprivation was starting to get to him again.

He shook the unfortunate thought from his head however, as he found himself already at Jim’s room where Spock stood somberly by the window waiting for them.

“How is he, Doctor?” Spock turned to greet McCoy and the unconscious Jim.

“He did alright, his lungs were pretty fucked, though. We couldn’t repair all the tissue we removed right away so he still has a regen unit in his chest for now.” McCoy gestured at Jim’s bare chest, taped shut with not much of an external scar left but with an odd, pulsing light emanating from under the skin.

“I see, and his recovery prognosis?” Spock was all business.

“Should be pretty good. Physically, once we take the regen unit and drains out his endurance will increase significantly and he should be able to handle the PT and drug therapies much better. Mentally… Jesus... I don’t know… I tried to talk to him about it, it didn’t really work though… in the end he didn’t have much choice in the matter after all.” McCoy regretfully looked at the pale kid, attached to so much equipment.

“But Spock, he told me he didn’t want to die… right before he passed out…”

Spock didn’t understand why McCoy looked so distressed at the good news but he recognized the signs of stress and fatigue lining the doctor’s face.

“Doctor, seeing that Jim seems to have handled his surgery well, why don’t you go home and get some rest? I will stay with the Captain.”

As tired as McCoy was, he shook his head,

“Nah, I told Jim I would be here when he woke up.”

* * *

“I think he’s about ready to come off the ventilator, he’s gonna be on CPAP for a while, though, at least until the regen can come out. When we let him breathe on his own it's always so damn shallow, he’ll give himself pneumonia again...” 

McCoy was anxious to have Jim come back to them. Sure, he would be unhappy with all the gear they had loaded on to him, but McCoy needed the comfort of seeing Jim’s blue eyes now, reminding him that the surgery was a success and Jim was, just maybe, ready to get better.

Spock stood back, respectfully detached as the respiratory team removed Jim’s breathing tube and transitioned him onto the CPAP machine. McCoy pushed several additional medications, methodically moving around Jim’s still form, checking the additional IVs and ensuring that his arms were lightly restrained to prevent him pulling the IVs out while coming to. McCoy wasn’t looking forward to this, Jim hadn’t been taking post-op… anything... very well lately. 

Even though the danger inherent in surgery had passed, McCoy still felt incredibly on edge. It was difficult not to disrupt the nurses flocking around Jim, trying to do all the necessary procedures while he was still unconscious. 

McCoy couldn’t handle anyone touching the kid, his professional detachment was deteriorating. He was beginning to feel the stress fractures of fatigue, annoyance, and worry, breaking down his mental walls.

  
  


Jim swam through the subconsciousness painfully, vaguely aware of the ache in his chest, the pounding in his head, and the feeling of air being pushed into his screaming lungs. He passively let the pain run through him as his mind began to register a terribly familiar feeling: the feeling of coming to with many pairs of unknown hands on him. He froze, unsure of where he was and what was happening, not wanting to provoke the hands he could not yet see, not wanting to let them know he was awake with the hopes that they would just leave him alone. But no, the hands were moving him now, readjusting him, touching his face, tugging at the new IVs in his arms. He was not awake enough yet to resist, his muscles still soaked in the anesthesia, so instead he played dead, surrounded by silent hands, the fear resulting in a blood pressure drop that nearly gave McCoy a heart attack.

“Jesus christ, Jim!”

Now there was a beautifully familiar hand on Jim’s cheek, and the sight of the angry doctor through his heavy eyes.

“What ya’ tryin’ to do, kill me?”

“Sor-ry Bones, but you were askin’ for it” Jim grinned sleepily, making McCoy’s heart jump again, but this time with maybe just a bit of hope.

Jim bit back his fear and pain, ignoring the indications of others still in the room, still touching him. He focused on Bones’ face, maintaining eye contact, memorizing his friends face, shutting out the world.

“Can you… make ‘em go away please Bones?” 

McCoy could see Jim twitching now, trying not to panic, as the medications wore off and the feeling of the others became obviously overwhelming. 

With the air being forced into his lungs by the CPAP and the pain blossoming in his chest, it was taking a lot of effort to keep calm, knowing that if he let himself get out of hand, he would probably just pass out.

McCoy dutifully cleared the room, nodding to Spock to leave them as well until Jim was ready.

While the fear and discomfort were evident in Jim’s eyes, McCoy tended to think that this was a small, but magnificent victory; Jim was coming back into himself, painfully, impatiently, stubbornly, but at least he was making an attempt to maintain control now, even if it was more for himself than anyone else.

McCoy had barely let optimism into his mind for sleepless weeks on end, but, here for the moment, a small seed was sprouting, a little hope that Jim could learn how to want to live again.

Jim closed his eyes, tried not to push against the restraints on his arms, tried to let the CPAP direct his breath, tried to surrender lest he be lost. McCoy held the man’s hand, staying silent, letting him be. 

He was just so grateful to have Jim with him


	15. Trouble

**Summary for the Chapter:**

> Maybe Jim being awake more often wasn't such a good thing, it only meant more opportunities to get into trouble, and Jim in trouble meant a very angry Bones.

**Notes for the Chapter:**

> I hope all of you are staying well!
> 
> I am sorry (yet again) for the delay. I've gotten a new writing setup (this time a tablet) which is taking me a little time to get used to but I am back on the writing train.
> 
> I hope you guys enjoy this one, I am trying out making the perspectives more diverse within one chapter, plus this one has Jim as the primary narrator!
> 
> As always I love to hear your thoughts!  
> Thank you for so much support!
> 
> Stay safe my loves!

**One week post-op**

Beep-beep-beep-beep-

Jim sank back into his pillows, annoyed by the distracting, endless pinging of biobed monitors. Bored and frustrated, he gazed at the ceiling for lack of anywhere better to look in his too-familiar hospital room. He should be used to the constant racket by now, but, for some reason, they were becoming more irritating by the day; maybe it was because he could stay awake for more than an hour at a time, though he hadn’t yet made it to two, maybe it was because they had been reducing his pain medication and the fog it produced in his mind was dissipating slightly, maybe it was simply that he was getting restless here. It didn’t matter why, the never ending beeping put him on edge. If he let himself listen to it for too long its constant tones would wind and twist in his mind, building up his lingering feelings of being trapped under all the equipment and his failing body, sparking panic until either Bones interfered or he fell back into restless sleep.

Unable to still and calm himself, Jim sat up slightly, trying to shake the anxiety from his body, his abs and back protested painfully until the bed automatically re-adjusted to meet him. Sitting up was a privilege he had earned since his lungs were healing nicely and he was becoming stronger. 

Eager to be distracted, he aimlessly flipped through the book Spock had brought him. It was a genuine, 21st century paper book, some science fiction piece about space that Spock must have thought he would find amusing. Jim had been genuinely surprised by the gesture, having never seen Spock, or any Vulcan, give gifts, let alone ones specific to the recipient. Bones must have mentioned Jim’s interest in old things, especially books. He looked at it lovingly, something human of his own in the midst of impersonal medical equipment. While he treasured the gift, he hated to admit that even after having the book for days he still hadn’t read more than a paragraph. He was just too damn uncomfortable to focus! 

It was so hard not to hate his body...

Even though he was  _ supposed  _ to be getting better, it didn’t stop the medical team from coming up with fresh torture devices to stick him with every fucking day. They had left an IV in his arm after the surgery and the regen unit often buzzed under the skin as it healed him, causing an uneasy ache in his lungs and ribs. This only added to the rest of his discomfort, of course. His life these days was a never ending carousel of tests and procedures. Whether it was the drug therapies that made his body burn, or the steady decrease in pain medication that often led him down the dizzying panic of being trapped in his useless, injured body, they all filled him with blinding pain just the same, without the knowledge of when it would end. It all always left him exhausted and afraid and hoping to be free, one way or another. 

There was lots for Jim to worry about now that he was coming back to himself. He had time -too much time- to reflect on whether or not he would survive, and what survival would even mean. He would probably spend the rest of his life in this damn place wondering if any of this was worth the pain, and fear, and loneliness. He would probably die anyway so what was the point? Coming so far with no promise of success only meant more unnecessary pain to Jim, it only isolated him more, made him question… everything.

In the midst of a flurry of doctors, nurses, Bones, Mrs. M, even Spock trying to encourage him, his hopelessness made him feel separate from the others, alone in more ways than one. Unsurprisingly, he spent a lot of time lonely these days as Bones fulfilled his other jobs in Georgia as a father and son, as well as joining Ali and Spock in constant meetings with Starfleet regarding the Khan incident and Jim’s recovery.

Jim was not privy to the goings on outside his room, he only knew that the world was moving very quickly, without him. 

He woke up every few hours to an empty room in a different shade of white as the days passed him by; when he did not wake alone, it was usually to someone drawing blood or administering medication and TPN through his line or IV. The softness and quiet with which the staff moved about him was unnerving, they had seen his panic attacks and how he often struggled when treated awake, they were apprehensive towards him and tried to only treat him while he was asleep, though, despite their best efforts, this often led to Jim waking, panicking, and Bones being called anyway. It was just flat out embarrassing, Jim wished they would just treat him like a normal person but he knew he would have to act like a normal person for that to happen and it just didn’t seem likely.

In the midst of uncertainty and pain, Bones was Jim’s only comfort, and yet, these days, he was an uneasy one. Things had improved between them since the surgery, he was more upfront with Jim now, more familiar, like the old Bones; however, even as Jim improved there was a dread behind his friend’s eyes, he was preserving hope for Jim, but seemed to have very little left himself, and Jim could see it, try as Bones might to hide his own hopelessness. 

When Jim was briefly awake and coherent, they treasured the time they could now spend together at the end of the day before Bones went home, but it was too often quickly eclipsed by whatever uncomfortable and invasive procedure Bones would have to inflict upon him the next day. 

Since arriving in Atlanta McCoy could feel himself becoming numb. Maybe it was the sleep deprivation he was forcing upon himself, worrying about Jim even when he left the hospital, punishing himself for leaving; but McCoy could find no peace these days. It was hard not to wonder if Jim would survive his next procedure, if he would even consent to further treatment, wondering just how far he could push Jim, wondering if he would ever be able to take Jim home. Things looked ok now, but McCoy was too seasoned a doctor to not realize just how fast a patient could go south. How much warning would he even get?

Jim finally gave up on his book, closing it forcefully even though it made his arm ache.

Dejectedly, he cast around for something to do, he was getting tired again but was convinced that if he could just distract himself, he might be able to fight the sleep that always trapped him.

His eyes fixated on the bioarch around his middle where the book still lay. It now functioned as a sort of table for Jim to rest any small objects he wanted to use as he couldn’t even reach out to the table beside him. Despite its innocuous appearance, the blinking lights on it made it clear that it was tracking every movement he made and every aspect of his health.

Multi-organ failure had meant that nearly every one of his bodily functions had been processed through the biobed at some point. He had even, apparently, been on dialysis for some time after his resurrection, though he supposed he was lucky not to remember those early days. That was only the beginning, he couldn’t ignore the line that still went in near the bottom of the arch that attached to the  _ unfortunate  _ urinary catheter, or the one that connected to the stoma in his abdomen which let him shit without ever leaving the bed, but left an awfully sore spot that he couldn't bare to look at. He supposed these interventions probably saved him the embarrassment of diapers or worse, but on top of every other drain and port he had, the ones in his more private areas felt way too invasive. It wasn’t much fun to let Bones change them either, but it wasn’t like he would let anyone else close when it came to things like that. It was perhaps the only time Jim was grateful for Bones’ medical detachment.

Compared to the invasive interventions, the IV in his arm and the mask on his face seemed pretty mild, but somehow, at the moment, they annoyed him even more. He had come out of the coma with the other lines inplace, he had no say in them, and as much as he hated them, Jim knew they were essential and improved his quality of life. It was the superficial stuff that was so easy to pick at; they had abandoned the IVs early on for a reason: Jim would tear them out, even sedated, and would violently struggle whenever someone approached him to use or insert one. They had hoped as he began to recover he would try to stop himself from damaging his gear but more often than not the sticker-like wireless monitors placed on his body would “mysteriously” disappear, the IVs would “fall out”, and most nasal cannulas would be ripped off, hence the mask securely affixed to his face. 

Jim was trying to restrain himself now, he really was, but the IV was itching and he was just so bored. It wasn’t even connected to anything at the moment! It was like they were keeping it in just to tempt him! He was sick of it, he wanted someone to come in and remove it- no he wanted  _ Bones  _ to come in and remove it. He hadn’t seen Bones yet today, Jim realized. Looking at the clock reading out only 0600 it was clear why, but he still wanted Bones’ attention, he  _ should  _ be here any minute.

He didn’t really think about it, distracted by the thought of Bones finally coming back after a night of strangers, but his thin hand wandered to pick nervously at the IV secured to his arm.

The one too many occurances of Jim ripping bloody IVs from his poor, fragile arms had made McCoy weary of inserting another; however, this time it couldn’t be helped, they had needed another line for additional medication and blood during the surgery and quickly discovered how much more convenient the IV could be during frequent medication changes since lengthy sterile central line procedures didn’t need to happen every time. The longer the procedure, the more likely Jim was to protest, so time was always of the essence. Putting it in his arm had been a risky choice but perhaps it was McCoy’s way of apologizing for subjecting Jim to so many invasive procedures, the arm was a hell of alot better than the groin. For security though, they had run the IV through an armband somewhat resembling an old-fashioned blood pressure cuff, this made the insertion point much less accessible and hopefully made the old thing a little less tempted for Jim, hopefully.

_ It really wasn’t his fault, _ Jim tried to reason with himself, the thing was so uncomfortable and he really didn’t even need it anymore, did he? The nurses just didn’t want to be around him, otherwise it would already be out, right? Nobody cared anyway. He doubted Bones would even notice its absence... as if. When it came to Jim, he missed nothing and Jim knew it.

Even with his shakey, uncertain hands it didn’t take long for Jim to wriggle the band off his arm, flinching as it caught the IV tube. He threw it aside carelessly, triggering the first silent alarm, unbeknownst to him.

Next came the IV itself, it really was a nasty thing; the insertion site itself was covered by a black tape -another unknown sensor- and the tube protruding from it seemed unnecessarily large. Jim looked at it with grim distaste, there was no way he still needed this dumb IV. He  _ wanted _ to think he needed none of the damn medical stuff, but he knew that wasn’t close to true; the IV though? Utter bullshit.

Jim pulled on the tube experimentally, it stung, but the pain was manageable, however, it did catch on the tape, stopping him from pulling it out altogether and triggering the final silent alarm. This didn’t deter Jim, he was too far in now. He ripped off the first layer of black tape and contemplated the layer of clear biofilm for a moment before ripping that off too. He had finally made it to the site itself, slightly red from all the pulling, stark and protruding from his skinny, white arm. The tube itself could be seen, bulging underneath his skin, making Jim slightly nauseous.

He closed his eyes, tried not to think about Bones getting mad at him, and yanked on the tube. Now alarms were going off in his room, this time not just at the nurses station and on McCoy’s PADD. The noise startled Jim into opening his eyes and looking around, he hadn’t really expected any IV monitoring since it wasn't connected to anything. 

_ He was such an idiot for thinking they weren’t spying on him every fucking minute _ , he chided himself.

Blood ran down his nearly translucent arm, dripping sickeningly onto the equally white bed sheets, Jim didn’t notice though, too distracted by the alarms to think much about their cause.

* * *

The quick succession of alarms going off on McCoy’s watch and PADD sparked terror and anger in his tired mind.

_ What, on God’s forsaken Earth, has he done to himself this time? I’ll never be able to sleep well again without being feet away from his dumb ass. _

He ran into the room in a mixture of fury and fear, followed by a sprinkling of worried staff fresh off morning handover. He was still clutching his things and a cup of coffee, unshaven and showing obvious signs of fatigue.

He stopped short at the sight of Jim, looking up guiltily at him, blood soaking into his bedsheets.

“Fuck, Jim…” McCoy didn’t know what to say, did he really believe another lecture would do any good? Did he even have it in him to control himself if he got started?

The silent, brewing anger scared Jim more than any yelling, he had never seen Bones look so filled with rage and not say a word. 

Casting his things down on a nearby chair, McCoy approached Jim followed by several ICU nurses. 

Roughly, he grabbed Jim’s bloody arm, shaking his head angrily as blood dripped onto his fingers. As he looked with pained eyes, he was still careful not to touch anywhere near the wound with his ungloved hands, he simply held Jim’s arm, staring at it as if in hope that it would tell him why exactly Jim continued to hurt himself. 

He gestured to the nurses to begin cleaning the site, ignoring Jim’s look of fear, silently begging him to do it instead.

With a disdainful grimace, McCoy said,

“Well, I’m glad you’re getting your dexterity back, Jim.”

Unsure if he could contain his anger, McCoy turned to leave the room. 

He paused, filled with a guilt of his own at Jim’s frightened and uncertain,

“Bones…?”

Turning reluctantly, McCoy knew he couldn’t leave Jim now but he couldn’t exactly stop his anger either.

Well, if gates of hell were opening anyway, why hold back?

“You absolute idiot!” McCoy couldn’t even register he was yelling, he was just too angry.

“Time and time again you do this, like a god damned child! I shouldn't have to tell you not to rip your IV out! Common fucking sense…!”

“But I didn’t even need-” Jim was looking worried now but stubbornly protested anyway.

“It's not up to  _ you _ to decide when to take out your IV, you infant! I decide what happens and when and you act like an adult and deal with it! Why is that so hard Jim? Please fucking explain…” McCoy finally realized he was yelling now, but it didn’t seem to stem his anger. 

He continued to stand beside Jim, coldly surveying the nurses mopping up blood and managing Jim’s arm. He ran a hand over his lined face, attempting to compose himself, only to look down and see his fingers coated in Jim’s blood and his reflection in the window, with a smudge of blood on his cheek. He felt sick, sick with worry and anger, and sick to see his hands covered with Jim’s blood. Again.

“Jim…” He went on heavily,

“you don’t have any idea what you could have done to yourself; you’re on blood thinners to help with clots, you could have bled to death in only a few minutes for fucks sake! Not to mention the risk of infection! I thought you wanted to live now!”

It was a low blow and his composure had eroded quickly, but all his fears kept coming true again and again, dragging him down, making him distrustful of any hint of progress, any light at all. More often than not, the setbacks were because Jim couldn't give himself a damned break! If all his fears were coming true, McCoy thought deep down, how soon would his greatest fear of losing Jim become a reality? How long did he have left to save his friend's life? It wasn’t like Jim was helping any.

The commotion sent Ali and Dr. Carter rushing in before McCoy could start in on Jim again.

“For God's sake Leonard, lay off for a second before the kid passes out.” Carter unceremoniously dragged a still furious McCoy from the room, leaving Jim, devastated and pale, alone with the nurses and a sympathetic, if bemused, Ali.

“I- I- It was so itchy! I thought it wouldn't matter…” 

“Oh, kid,” taking pity on a truly grief-stricken looking Jim, Ali waved away the nurses and finished wrapping Jim’s arm, subtly and quickly adding more monitoring tape and a fresh cuff, but not attempting a new IV.

“you know this is serious, right Jim? You’re at massive risk for infection and touching your IV with dirty hands…”

Ali wasn’t quite sure how to talk to Jim about this. He had stood in the corner, watched Jim and listened to McCoy fret about him and the possibility that Jim would sabotage his own recovery, but he was rarely in the thick of it. Even through all his observation, the young captain was an enigma to Ali. But now, alone with the kid, unsure of when McCoy would be able to come back, he knew he needed to think of something, some comfort for Jim at a time when he felt most abandoned.

Jim didn’t look at the doctor. Sure, Ali was the most familiar of the medical team, outside of Bones, but Jim was still hesitant to trust him, unsure of what he would do, especially nervous whenever Bones left the room. With limited access to his childhood medical records, Ali had a vague understanding of Jim’s trauma, supplemented sparsely with information provided by McCoy. Even with this limited knowledge, it was clear to see that Jim did not trust medical professionals and had experienced severe abuse at their hands, clearly starting in childhood. He was smart enough to keep his distance when at all possible, there was no point to causing Jim more stress, but as time went on, the necessity for Jim to accept treatment, not just for his own immediate safety, but also to preserve his future, became more apparent and with McCoy’s growing fatigue, Ali had stepped up, intent of helping Jim regardless of his protests. Ali was a stubborn man, he had to be if he wanted to work for McCoy, he wouldn’t give up on Jim, he wouldn’t stop the treatments until he was ordered to, an order he knew he would never receive from McCoy, he only hoped that Jim could interpret his stubbornness as sympathetic and not frightening. 

Having finished tending to his arm, Ali, unsure of what to do, drew some blood from the port to check for infection and busied himself monitoring the other vitals, hopefully giving Jim some room to contemplate what just happened.

Jim was completely quiet, frozen by the overwhelming sense of his mistake.  _ He  _ had caused Bones to leave him, maybe forever? He had fucked everything up, no wonder everyone left in the end.

He stared straight ahead, lost to the real world, unsure if he could even breath through the fear and sadness squeezing his chest. He was going to be alone again. Alone in this horrible, scary place. He had just wanted a little bit of freedom and now he had messed everything up and he deserved everything he got, no matter how unbearable. The tears felt cold against his hot face, he didn’t bother hiding them, knowing that Ali had turned away to give Jim privacy. He was a good guy, Ali, but he couldn’t help Jim, Jim couldn’t live without Bones, he didn’t want to.

The whole ordeal had left Jim completely drained, he had been tired before, but now, he had the overwhelming sadness to contend with and he wasn’t sure he even wanted to wake up again if Bones wasn’t there beside him. He was drifting in and out of sleep, deep fatigue mixed with freezing panic, he wasn’t sure if anything could make him feel better, he wasn’t sure if he could feel safe, if he could sleep, no matter how desperately he wanted to leave all of it behind him.

He shifted in his bed, beginning to feel trapped and panicked again, the monitors protested loudly but were thankfully silenced quickly by someone. He didn’t care, instead of sleep, the dizzying darkness of panic was closing in on him.

He barely registered the new alarms screaming, only the cool hand stroking his face and hair, only the gentle, familiar whispers,

“Hey baby, why don’t you try to take some deep breaths for me. It’s ok honey, you’re ok.”

Mrs. McCoy wiped the sweat and tears lovingly from James’ face, the face growing so familiar she now recognized it as one of her own. Her son had called her in once his rage had dissipated slightly, to her surprise, despite a calm demeanor he refused to join her in James’ room, instead begging her to take care of him, to make sure he was safe. Leonard was often angry, it had become a cornerstone of his personality despite her best efforts, but it was rare to see him genuinely distraught. She had questioned him, never knowing he son to walk away from anything, even temporarily, but he looked away saying simply that he needed time, but he equally needed someone familiar to look out for James, he just couldn’t be that person right now.

“Darlin’ it’s ok, don’t you worry about anything right now. Shhh… you’re not alone”

James fitfully shook his head at that, eyes screwed up and teeth clenched.

“I made him leave! I fucked it up! He’s gone forever because of me-” A sob escaped him.

“Aw child, don’t you worry, Leonard would never leave you. You did give him an awful scare though, James.” Her voice was sober, but somehow still comforting.

“He just needs some time, you can understand that, right?”

Still sobbing quietly, Jim nodded his head in agreement. He was so sad, but he had to deal with the results of his actions, he had to do it for Bones.

* * *

McCoy watched silently from the observation window into Jim’s room. Looking at his mother cradling Jim’s head and looking at the monitors now indicating that he was asleep, McCoy began to calm. He took his first real breath since he had seen Jim that morning, more of a gasp than anything. Even though relief was flooding him, he couldn’t take his eyes off of Jim, he had to make sure he was safe, always. He didn’t want to think about what would happen if he failed again, maybe he didn’t want to think at all.

**Notes for the Chapter:**

> I am thinking about maybe going back and editing some old chapters for clarity and/or just simple mistakes, what do you guys think? Would you be interested in going back and reading them? There might be some new stuff added but I can't promise they will be different chapters altogether.  
> Please let me know your thoughts!
> 
> Also, do you think this chapter needs additional tags? I'm not sure if I am getting too much into the realm of self-harm or something to not have tags.


	16. Together

**Summary for the Chapter:**

> Through Bones, surviving anything seems possible.  
> Without Bones, life barely seems worth living.

**Notes for the Chapter:**

> What crazy times we're living through, am I right?
> 
> I hope you are all staying well and safe.   
> I am a bit of a wreck at the moment so I once again thank you guys for your patience and forgiveness about my infrequent posting.   
> My new writing setup also needs some work so please excuse the errors, when I come back and edit these again I will hopefully catch them.
> 
> I have seen many of you express interest in me going back and editing old chapters so I guess that will be my next project.  
> I will put REVISED in the titled of every chapter I edit so we can all keep track. Keep your eyes out for them but I don't know how long it will take me because I will have to force myself to go back and read my cringy old shit.
> 
> Love you all! Stay safe!

“Lie back down, Jim” Ali warned as he initiated the bioarches surgical protocols and sterilized his hands.

Jim craned his neck as a nurse and Mrs. McCoy tried to keep him still. He just wanted to see what they were doing to him, was that so bad? It wasn’t like he was fighting them… much, at least.

Flat on his back, with tight-lipped people all around made him nervous, it harkened back to times long ago when there was no one to protect him, no one who even cared, no Bon…

_ Where was he? _

This time Jim nearly succeeded in getting his upper body off the bed before a surprised Mrs. McCoy once again lovingly, but firmly, pushed him back down, strapping him in before he could cause any more damage to himself.

Due either to his growing sense of panicked disorientation or his bony chest bared to the air in preparation for the removal of the regen unit, Jim began to shiver uncontrollably. Shaking his head as if to wiggle away from the hands that were touching him, the hands that weren’t Bones’.

Unable to move, but equally unable to surrender, Jim desperately squeaked,

“Bones-? Bones!”

“Hush, James,”

Mrs. McCoy was equal parts sympathetic to her son's anger at Jim and incredulous at his unwillingness to put it aside for a necessary procedure, but she supposed this wasn’t the time to contemplate his actions, that could come later. If Leonard refused to be there for Jim, then by God, she would!

“Leonard couldn’t make it, love, but I promise you, you’re in excellent hands.” 

Jim couldn’t see from his disadvantaged position, but she cast a somewhat doubtful look at Dr. Ali. No one was as good as her son, no one.

“He hates me-” Jim was breathing quickly now, it was hard to tell which was louder, his heart pounding in his ears or the monitors screaming.

“Shhh baby, Leonard doesn’t hate you, he just needs some time. You’ll be ok and he’ll be back before you know it.”

“No! He wants me to die! He wouldn’t leave me if he wanted me to live! I made him- I’ll die…”

Bones was always there… Jim had been sure that as much as he pissed off Bones, he would always come back, he would always come back unless he just plain didn’t want Jim anymore. And if Bones didn’t want him anymore, Jim’s head spun parilously, then what the fuck was even the point? He was basically a helpless infant now and if Bones was gone, he was as good as dead.

The thoughts ran round and round Jim’s confused mind, twisting him up inside with a painfully familiar sense of abandonment that he had tried for so many years to stop feeling.

* * *

A wave of icey guilt washed over the watching McCoy. From his vantage behind the oneway observation barrier he could see and hear everything, he could see and hear Jim suffering, burdened by the knowledge that it was because of him. He cursed himself for being such a stubborn, sulky asshole but didn’t move. Jim would be fine, he told himself. He would be fine and then we can work this out. He will be just fine.

He knew better than to believe the lies he was telling himself, he knew that he knew better,  _ and still _ , he did not move.

  
  


* * *

  
  


Ali had to work quickly, Jim was obviously panicking but the extraction had to be done and the longer they waited the more traumatized Jim would be. He wasn’t a stranger to Jim’s panic attacks by now, so why should this one be any different?

The local anesthetic via spinal tap was already taking effect, but the loss of feeling in Jim’s chest only served to scare Jim more. Why was this happening? Had someone told him about it? Why couldn’t he remember?!

Probably because it wasn’t Bones who had told him. Probably because it had been hours since he had even seen Bones, hours since he had been removed from Jim’s room. Jim had been in a haze ever since, nothing mattered anyway, Bones didn’t want him to live anymore.

Jim was in the throws of panic before Ali could finish his first cut. His heart rate was spiking, his temperature was dropping, and his blood pressure fluctuated rapidly, he was going into shock before their eyes. Perhaps Jim’s body was already so used to the physical trauma that usually accompanied his breakdowns, perhaps without Bones he just couldn’t cope.

The superficial cut was already gushing blood; it should have been an extremely easy procedure. Jim’s own mind was his worst enemy, if he didn’t want to live, if he didn’t fight his failing body, there was nothing anyone could do.

McCoy couldn’t stand by anymore, any resolve had melted away as quickly as Jim began to slip. He rushed into the room surprising no one but still roughly pushing them aside as he hurriedly prepared to operate. The team had the good sense, and practice, to step out of McCoy’s way, though Ali still stood by Jim’s side, scalpel in hand, eyes on the monitors, a look of horror on his face. 

“God Dammit Jim! Stop this bleeding shit!” McCoy’s hands flew as he cauterized, removed the regen unit, and packed the wound, swearing and shouting orders all the while.

More blood, more gauze, more fluids dammit! 

It all meant nothing to Jim. 

Even though McCoy appeared angry and loud, anything but comforting, Jim’s vitals were slowly stabilizing, as if McCoy was singing him a lullaby.

Jim’s heart rate slowed, he stopped shaking, and his eyes closed in relief and exhaustion.

“You came?”

The voice was quiet, shy and hesitant, desperately searching for some kind of closure. 

“Of course I fucking did!” McCoy shook his head indignently, but didn’t look at Jim’s pale face.

“You-you didn’t want me to die?”

McCoy was silent for a moment, focused on examining Jim’s open chest in front of him.

“No Jim, of course not… I never really left you. I never will.” 

The room was beginning to empty slowly as Ali cautiously waved people away. Now that McCoy was there it would probably do more harm than good to attempt to help with Jim’s procedure.

Still, Ali and Mrs. McCoy hovered in the corner, unwilling to leave the volatile couple alone, always prepared to help if Jim began to go south again. Perhaps more than that though, a sort of fascination held them; watching the two men reconcile while Jim’s chest was still open, while he was incredibly vulnerable, it was unique, strangely gentle in the midst of so much pain and chaos. There was no need for words as McCoy’s quick hands placed the regen probes into the remaining layers of muscle. Jim lay still and complacent, eyes closed, as the pain and fear melted from him.

  
  


“It's incredible, isn’t it?” Mrs. McCoy leaned towards Ali so as not to interrupt them.

“The way Leonard calms James just by his very presence. It's like they speak a silent language that none of us can hear.”

Ali nodded thoughtfully,

“I don’t think Jim feels safe without him. Ever.”

* * *

McCoy’s hands moved furiously, hoping to spare Jim’s body any more blood loss or trauma. Despite Jim’s progressive stabilization, McCoy’s eyes flicked back to the screens every few seconds, his hands working with practiced ease without prompting.

Seeing that Jim was finally calming in his presence, McCoy’s eyes came to rest on Jim’s now flushed and tear streaked face. He furrowed his brow, contemplating his patient, and friend; feeling the anger begin to leave his body, the adrenaline dissipating, and a wave of exhaustion, guilt, and painful sadness washed over him. Bowled over by the emotions he had been repressing all day, he nearly paused in his work, but those steady hands gave no mind to their master’s turmoil.

Having finished the last layer of regen and beginning the surgical exit protocols, McCoy finally spoke to Jim again,

“Jimmy, I’m real sorry I left you today,” McCoy briefly closed his eyes, collecting himself,

“I’m gettin’ old, kid. I don’t know how many times you can scare me like that before my heart gives out altogether. I know you hate being here by yourself, but I can’t always be with you in this place, and just because I’m not here, doesn’t mean you can stop gettin’ better.”

The protocols done, McCoy put a comforting hand on Jim’s cheek. He knew Jim wasn’t sleeping from the monitors, but the look on Jim’s face was clearly, at least to McCoy, one of relief, not resentment. 

_ He must be tired too. _

“Look Jim, I really want to get you out of here, and I know you want out too, so I’m gonna need you to follow the rules this week, I mean  _ really  _ follow them, then, if you stabilize, we can bring you to Momma’s. Then everything will be… ok.”

The uncertainty in his statement surprised even McCoy. Maybe he didn’t really think Jim would cooperate, or worse, maybe he didn’t believe things could get better, maybe things would never be ok again. Had he been putting too much trust in Jim, and himself, all this time?

_ No way,  _ he thought.

_ If anyone can survive something as unsurvivable as death, it's definitely Jim. Any if there’s a doctor who can help him, it's sure as shit me. _

Jim opened his big, blue eyes, squinting in the light, but obviously relieved at the sight of McCoy in the flesh,

“I get to leave?” 

_ Of course that's the only part he got out of my little speech. _

“Yes… If things go well,  _ and you behave _ , I will take you home. It won't be that simple though, unfortunately kiddo, we can talk more tomorrow but I can tell you I’m gonna need you to switch to the NG tube and you’re going to have to show your willingness to participate in your PT and psychotherapy.”

Jim made a face but McCoy’s sigh made him quickly follow it up,

“I’ll be good! I just need to sleep. I don’t want to think about this anymore right now. Please don’t leave Bones… I just need to sleep.”

At that, exhaustion hit McCoy again too, inescapable this time, he could feel Jim’s fear and pain, and he was just so tired. Collapsing into the nearby chair, he tightly held Jim’s hand in his own. His eyes were only open enough to watch the monitors as Jim fell into a painful, but relieved, sleep.

It was only then that McCoy's thoughts could wander outside of Jim’s little world.

McCoy thought he knew about heartbreak when Jocelyn left him, when he left the state he loved, when he lost everything but his bones, but watching his friend struggle for all this time, watching him fight for his life and fight his own mind, watching him scared and in pain, it was another sort of heartbreak, one he had to experience again and again, every goddamn day. 

Hand in hand sleep overtook them both, not peacefully, but thankfully together.


	17. Update from the Author

**Summary for the Chapter:**

> Hey guys!  
> I haven't been writing a whole lot but I don't want you to think I am abandoning this story!  
> This is just a small update on the project plus an announcement.
> 
> Love you all!

Hello everyone!

I am so so sorry that I haven’t been able to update this story in a while.

I’m currently going through a health crisis and am caring for my teenage sister by myself so I have been incredibly overwhelmed. It’s not an excuse, just an explanation. I really want to get back into this story as I love it dearly but I am struggling and my time and concentration are pretty limited. 

I am sorry!

I have lots of ideas and love for this story but the actual act of writing it has been extremely slow lately so I am announcing an opportunity to contribute to the project and collaborate with me! 

If anyone is interested in helping me revise existing chapters or collaborate on my new ones, please reach out.

I am eager for a fresh perspective and some motivation in order to produce new work more quickly and more thoroughly revised chapters.

To be absolutely clear, this story is not being abandoned or given away regardless but it is getting a little too big for me at the moment. I am really excited to publish my newest chapter, hopefully this coming week, and with some additional help I think we can publish other revised chapters (and new ones) fairly quickly.

If you are interested in keeping this story alive please reach out to my writing email address:  [ theuncertaintyprinciple99@gmail.com ](mailto:theuncertaintyprinciple99@gmail.com) and let me know if you want to proof or collaborate

I look forward to hearing from you guys and working with you in the future!

Sorry again! I miss you all!


	18. You Nourish Me - Enough

**Summary for the Chapter:**

> Jim is making progress. Slow, painful progress, of course, but a steady trudge towards going home.   
> Now that Jim is ready to learn to eat again and make the last hard push to home, it's clear some motivation would greatly help. McCoy believes it's time to begin remembering the outside world and all the joy that Jim has waiting for him as he recovers.   
> This time, joy and motivation come in the shape of Jim's favorite little niece.

**Notes for the Chapter:**

> I'm finally back!  
> This chapter has been antagonizing me for a while now but I seem to have beat it into decent shape so I hope you enjoy! Thank you all for your patience, writing is sometimes a slow, difficult process but I always come back because I love the story, the boys, and of course, all of you!
> 
> I have to give the BIGGEST shout-outs to my awesome editors who pushed me to finally finish this chapter and actually made it readable!  
> Finnegancat, for her amazing mechanics advice. I am already a better writer from her help.  
> And PrairieDawn, for all her suggestions in both style and content, especially her medical logistics advice.  
> If you like this chapter you definitely have them to thank!

“Ok Jim, now take a deep breath, that’s good... and now a sip of water, I am going to insert the tube down as you swallow, just like always.”

One hand gently holding Jim’s chin in place, McCoy handed him the paper cup, ignoring the shaking hands, while closely watching him take a tentative sip as McCoy began threading the hated nasogastric tube down Jim’s throat. 

Despite the anesthetic cream on the tube, Jim gagged violently as soon as it hit the back of his throat, making him sputter and choke on the very small amount of water. Some of it dripped out of his irritated nose, unmistakably streaked with snot and blood.

For the millionth time, as McCoy watched Jim nearly throw up his feeding tube, he lamented the loss of Jim’s gastrostomy tube. Originally, it had seemed like the ideal solution when there was still hope of Jim digesting liquid nutrition on his own; a simple tube in the abdomen was much harder to pull out than an NG tube and a lot more comfortable.

Unfortunately, while Jim was on nearly constant infusions of Khan’s blood, his body had rejected any and all forgein substances and equipment. They had innocently placed the gastrostomy tube and within hours learned their lesson as Jim’s body violently rejected it, nearly inducing sepsis in the process. Despite its immediate removal, McCoy feared the wound would never heal, even with constant regen therapy; modern technology bested again by bad blood circulation and an immune system as stubborn as Jim himself.

They didn’t dare insert another, nor any other foreign body that wasn’t accompanied by immunosuppressants or a regen unit constantly healing the subsequent, and unavoidable, damage. Even as Jim was improving every day, reactions were constant. Permanently covered in welts and hives, the area around his IVs and lines were stained deep red from tape and biofilm. Full body stem cell baths could only do so much if he had to immediately go back to the very things injuring him. He had to get fluids, lipids, and calories, he had to have blankets and clothes, the breathing tubes and IVs were often the only things keeping him alive. For now, the pain and irritation was as inevitable as it was necessary. 

Once the tube firmly landed in Jim’s stomach and the coughing stopped, McCoy let go of his head, tousling his hair and lightly saying,

“See, that wasn't so bad, you big baby.”

Jim huffed indignantly, already absentmindedly rubbing the biofilm affixing the tube to his cheek. Red marking immediately became visible around his nose; more steroids would definitely have to be added to the night's meds. That would be fucking fun, as if the tubes themselves didn’t already make Jim angry and sulky.

“You watch it, Jim!” McCoy grabbed the wandering hand, holding it up between them with a scowl.

“If you pull this tube out, I swear to the lord above, I will keep you in this fucking hospital bed until the end of time!”

His voice was more serious than it should have been and he knew it, but it wasn’t like he hadn’t been through this a million times before with Jim. Recently too, dammit!

The only thing that was keeping Jim on track now was the promise of leaving the hospital, so he squeezed his eyes shut and tried to breathe through the continued discomfort, his throat raw and the taste of blood still very present in his mouth. 

The formula hadn’t even started flowing and he was already feeling nauseous. Maybe if this wasn’t the third try at an NG tube this week; maybe if he didn’t keep throwing up the formulas, along with the tubes, every time, then  _ maybe _ it would be easier to feel hopeful that this time would be different. The passive hopelessness was evident by Jim’s resigned compliance as McCoy checked to see that the tube was placed correctly, connected it to the formula, and set the pump. It was also evident, though more subtle, in McCoy’s body language. His hands were steady, and his face was neutral, all attempts to keep Jim calm, but his stance was slightly defensive and there was doubt in his eyes.

McCoy never wanted to show it, or acknowledge it to himself even, but the doubt was a growing rock in his stomach. He felt the weight constantly dragging him down. Getting out of bed was harder every day and meals felt wrong knowing that Jim wasn’t able to eat. Often even thinking about Jim while not at his bedside sent a spiraling panic coursing through him. 

  
  


_ Why though? _

  
  


Since their reconciliation and a more concrete promise of going home, Jim had been making steady improvement; however, every victory was hard won. Every ounce of weight he gained and every minute longer he stayed awake was a miracle to McCoy, even if Jim couldn’t see it himself. So why was McCoy so damn down?

  
  


_ And why the fuck was he growing to dread Jim coming home? _

  
  
  


His heart ached at the sight of Jim, unhappy and discouraged, usually alone in his hospital room. He desperately wanted Jim home with him, but fear was always in the periphery; at home, the options for serious emergency intervention were significantly diminished. If something went wrong, it was likely it would go very wrong. McCoy was good at working with what he had, Star Fleet had taught him that at least, but what if it was too soon? If something went wrong, if McCoy was making the wrong decision to let him go home… he didn’t think he could live with himself. He knew what losing Jim felt like, he couldn’t go through that again.

McCoy had to remind himself that his own paralysis was as deadly to Jim as any other threat and that the failure to move, to improve, was, in itself, a step towards defeat. Jim would only heal so much in the hospital. It was more than evident as his mental state failed to improve at the same pace as his physical progress. Because Jim was such a social person, the loneliness and the separation from his work and the real world didn't allow him to see the life being lived around him. To Jim, not seeing life meant there was no life at all. Jim needed just a bit more time but time required patience and for Jim, patience required an incentive. If anything could incentivise Jim it would be to bring a little life into the hospital for him; a little life in the shape of the people Jim loved the most. In the midst of the relative isolation of the hospital, Jim wouldn’t have to spend the evening alone.

  
  
  


The halls were quiet as McCoy ushered his guests towards Jim’s room. The words of warning, of preparation, were still hanging tangibly in the air between them all.

_ “He’s still very fragile, he won't be at all like you remember him, Jojo, but that doesn’t mean he’s a different person, his body has just been through... a lot. He has just been through a lot. You need to be gentle with him.” _

_ Jojo didn’t speak, her father’s serious tone scared her more than the warning. She had no idea what to expect and her excitement at seeing Uncle Jim was quickly turning to apprehension. _

_ “You can’t play with him like you used to, but he will still be happy to see you.” _

_ “Leonard, stop scaring the child.” Mrs. McCoy put her arm comfortingly around the small girl. _

_ “Baby, Uncle Jim is sick but he very much wants to see you and everything is going to be alright.” _

_ He knew his mother meant every word, but McCoy couldn’t help but feel that he might not be preparing his daughter enough. _

_ Jim needed to see them, wanted to see them more than anything, but McCoy felt oddly apprehensive. He trusted his daughter to behave, of course he did, and he trusted Jim too, though more incredulously, a protective twinge in his heart made him want to shield them both from the reality of Jim’s condition. McCoy feared that the meeting between Jim, who had spent the last several weeks flirting with death, and Jojo who was all too full of life, would expose just how far he was from the old Jim who used to frolic with Jojo and bring to light just how far he had left to go. No doubt Jim needed some tangible motivation to continue with his recovery, but McCoy was sceptical that both Jim and his daughter would respond appropriately to one another. Things were so very different. _

The light in Jim’s eyes and a smile to match the Georgia sunset in the window quickly erased the worry from McCoy’s mind.

“Jojo!” Sitting up as much as he could, Jim greeted the little girl still clutching her grandma’s hand in the doorway.

“Come in, come in!”

Damn, it had been so long since anything good happened. Jim’s cheek muscles were already beginning to protest and the bed couldn’t possibly rise fast enough to meet his back before it gave into spasms; luckily, the slight fall back onto the bed was only noticed by McCoy who watched on silently, not wanting to ruin the reunion of, quite possibly, his two favorite people in the world. He was still making mental notes, of course. Jim’s damp forehead and the sweat soaking the back of his shirt, was as much a testament to his stubbornness as it was to his love for Jojo despite the pain. It didn't matter though, syringe already in hand, the good stuff would be in Jim’s line before he would notice McCoy’s movements, the slow process of weaning him off the painkillers would be for another day, Jim deserved one good night, they all did.

With an encouraging nudge from Mrs. McCoy, Jojo stumbled nervously into the quiet room. 

_ Uncle Jim really did look different but his smile was kinda still the same and she had to be brave for him like her father told her. _

Her smile reflected his own before she even reached his bedside

Uncertain what to do, she stood beside him, staring innocently at her uncle now covered in wires and tape. It was both fascinating and frightening and only his words drew her eyes back to his face.

“How’s it going, Sunshine? Miss me?” It really was her uncle, she could tell for sure now.

“Yes, Uncle Jim! We have all missed you so so much!” 

As if presenting evidence to her claim, Jojo withdrew a crumpled piece of paper from her overall pocket and shyly handed it to him. 

“MeeMaw and I made this for you while Daddy was at the hospital. She said you needed some art in your room and  _ I’m  _ the best artist she knows,” she said with pride.

With slightly shaky hands, Jim spread out the creased paper on his bioarch, studying every inch of it as though it was the last thing he might ever see.

“Jojo… you made this for me?” 

The shine on Jim’s face wasn’t just sweat anymore. He couldn’t take his eyes off the drawing. 

“It's me and you and MeeMaw and Daddy and Fred” Jojo finally moved closer to Jim, snuggling up beside his bed and pointing to each stickfigure in turn, ending with the disproportionately giant goldfish in the corner.

The pained look that had choked out Jim’s thin features since the coma was beginning to lessen slightly and with it, the rock that had lived in the pit of McCoy’s stomach for all those weeks seemed a bit less cold and heavy. It was a scene he couldn’t take his eyes off; a scene to rival Jojo’s drawing even.

The moment seemed too perfect to ruin with a topic change but Jim probably wouldn’t be able to stay awake for much more than an hour. The main goal was to get him to eat… er- at least some ice chips and formula. 

Always the mind reader, before McCoy could say anything his mother was opening containers filled with food and even laid out a cup of ice chips for Jim. The smell of food finally broke the pair away from their goldfish related conversation and both of them eyed the food, one with excitement and one with a mixture of sadness and… fear?

McCoy had some concerns that even the sight of food would make Jim gag but he chose to hope that it would motivate him instead.

“Ok Jimbo, I am gonna start the formula drip but really, really slowly, you just try to suck on the ice chips and enjoy us fine people.”

Jim’s half-grin was back, but his hand went self consciously to his nose and the hated tube. McCoy’s disapproving look quickly snapping him out of it as he connected the bag of milky, light brown liquid.

“Ok kids,” Mrs. McCoy gestured for them to sit down, pointedly directing her words to her son who had continued to fuss over an embarrassed looking Jim.

“Let's eat before everything gets cold.”

Sinking heavily into his familiar chair beside Jim’s bed, McCoy realized it had been weeks since he had eaten within the hospital. During his, now limited, time with Jim he was constantly running around, only realizing after 12 hours that the only things in his stomach were terrible hospital coffee and worry at leaving Jim alone until the next day. It felt wrong to just… sit there, no reports, no procedures, no heart-to-hearts or arguments, just him, just Jim, and the people he knew were family to both of them, the only real family they had. 

It was intimate in a way that made him feel just relaxed enough to take a bite without even realizing it.

“Wow Momma, fantastic as ever.” McCoy closed his eyes in momentary peace.

As the dinner wore on with Jojo talking a mile a minute to her amused audience, peppered occasionally with a reminder to eat from her grandmother or a question from Jim, his attempts to conceal the growing discomfort became less and less effective.

It was hard to tell if it was the tube or the smell of food, or just the effort of suppressing his pain in front of other people but the sweat had begun to seep through the front of his shirt as well and even though his expression was pleasant, he had stopped talking in favor of listening to the little girl with adoring, if somewhat forced, attention.

“Well Jojo,” Mrs. McCoy, prompted by a look from her son, began to clear the empty plates,

“I think it's getting close to your bedtime. We still have to get up for church tomorrow.”

Tossing aside her fork the child rushed to Jim’s bedside, grabbing the bed sheets as if to prevent her grandmother from dragging her off.

“Nooooo Meemaw! I am gonna stay with Uncle Jim until he gets to go home! Right?” Her big brown eyes turned to him expectantly for backup.

“I’m sorry kiddo,” he lifted his hand to tussle her hair but thought better of it as his arm began to shake,

“I wouldn’t dare go against your Meemaw. Not even your dad and I are that brave.” 

The adults in the room chuckled at Jojo’s pouting and, for the first time, Jim felt like one of them, not just another child to boss around.

“Come now, say goodbye to Uncle Jim, you’ll see him in a couple days anyway, we can draw lots more pictures for his room tomorrow if you’re a good girl and go right to bed when we get home.”

A quick hug of Jim’s arm and the child and Mrs. McCoy was gone, most of Jim’s energy abandoning him with them.

As soon as they exited the room, Jim’s carefully constructed mask began to falter as the exhaustion hit him.

Eyes closed, he didn’t bother to watch whatever Bones was doing to his IVs, choosing to rest his painful head and relive every precious moment of the dinner.

“Thank you, Bones…”

McCoy looked up but Jim didn’t open his eyes,

“I hope it wasn’t too much for ya, kid. You did such a good job.”

Jim smiled slightly,

“No. It was... perfect.” 

Before sleep could fully claim him he opened his eyes just a bit again,

“Hey Bones? Could you… help me… this shirt, I fucking soaked it… sorry.”

  
Despite his very unusual appeal for assistance, he began an attempt to take the shirt off himself anyway, nearly managing to wriggle it halfway up his chest before his arms gave out.

“Fuck fuck fuck.”

“Woah kid,” McCoy placed a gentle hand on the heaving chest and removed the shirt in a smooth motion,

“There ya go, no fuss.”

Of course when Jim  _ finally  _ asked for help there still had to be struggle,  _ of course  _ there would be fuss. But it was progress, sweaty, fussy progress.

Jim balled the shirt up angrily in his shaking hands,

“Fuck this.” 

His feeble throw couldn’t even get the shirt off the bed and did nothing for his spirits; he was just too tired for this.

Before Jim could wind himself up anymore, a cool washcloth was being wiped over his face, chest, and back and he was a little fucking child in Bones’ hands again.

A grimace and a fresh shirt later and Jim once again laid back with his eyes closed.

McCoy couldn’t help himself though, of course Jim didn’t see the progress, he never did, but that didn’t mean McCoy had to enable his childish blindness.

“Look at me, Jim.”

Characteristically Jim’s eyes stayed closed and his  _ leave me alone  _ expression was conveyed through a pout not unlike Jojo’s.

Not deterred, McCoy took Jim’s head in his hands, watched him finally open his eyes with some surprise and went on whether Jim wanted him to or not,

“You did so well Jim, you’re almost there, you’ve almost made it out.” 

Of course Jim wouldn’t believe that,

“You did it and you did it while making Jojo - while making me - happier than I’ve been in a long time.”

Yeah, sure, it was sappy as hell but the relief the successful dinner gave McCoy was enough to make him slightly more like the teddy bear Jim insisted he was under the ‘grouchy old doctor mask’.

It was hard to tell if it was disbelief on his friend's face or actual happiness, but either way, it was so much better than it had been.

As the sleeping medication began to work, Jim’s mixed expression seamlessly turned to a vague smile, then a vague grimace, and finally something resembling peaceful sleep. 

McCoy gently laid Jim’s head back onto the pillow and sank into his chair once again. There were more meds to administer, more praying that the formula would stay down, more of all the things that had become his world since the accident but this world was just a little less dark for the moment as the light faded from the room and only the memory of Jim and Jojo were left to light McCoy’s night.

Damn, would the two be a handful, but fuck, did he love them so both so much.

It was worth it, he decided, before sleep tugged at him as well; Jim was really, actually ok for now, so could a little nap really hurt? 

**Notes for the Chapter:**

> Unfortunately, I am unsure of when my next chapter will be coming out but I have received some revisions for earlier chapters from the lovely Finnegancat so they should be up a couple at a time in the next week or two as soon as I can edit them.  
> I am currently beginning the drafting process for my NaNoWriMo novel so that will be taking up a lot of my writing time but I will continue this story as time/energy permits. This story definitely has more to give so its not over yet. 
> 
> Thank you again for your support!


	19. The Last Morning

**Summary for the Chapter:**

> Jim and McCoy prepare to leave the hospital and venture into Jim's recovery at home.

**Notes for the Chapter:**

> Well everyone, its been a long in the making but this part of the journey has finally come to an end!  
> This will be the last chapter of "A Long Way to Tomorrow"  
> I have high hopes and ideas for the next leg of Jim's recovery but at the rate I am writing I feel that they would be better placed in a different piece within the same series. I can't say for sure when I will begin on this next piece but it will definitely be after NaNoWriMo is completed. 
> 
> The story, characters, and all of you are often in my thoughts and most certainly not forgotten.  
> Your kudos, comments, and suggestions have made a world of difference to me and my writing.  
> Thank you all for making this such a special experience for me and I hope I made it an interesting read for you!  
> I will be back in the not so distant future!  
> Love you all!

Morning meant many things to Jim now. Morning meant southern sun streaming through his window, morning meant vitals and blood taken from him before he had fully surfaced from sleep, morning meant the slightly sick feeling from the TPN and the  _ very  _ sick feeling as, drop by drop, formula was forced into his stomach despite its protests. Most importantly, morning meant that Bones was coming back and the restless night could finally be over. 

“Hey, kiddo”

_ Wait... he’s early? _

Jim’s eyes were closed, all his energy focused on not throwing up the formula, but the furrow between his brows deepened in tired confusion.

“Today’s the day, Jim!” 

A cool hand on his cheek prompted Jim to open his eyes to see Bones’ unusually cheery face staring down at him.

“Wha-?”

It was more of a groan than anything as he suppressed a gag from the tube down his throat. 

“Wake up, lazy! You’re going home today!”

_ Ah, that’s right! _

Boy, was he awake now. White lips pressed into a weak smile, but a smile, nonetheless.

Bones was fussing about, moving Jim to a more upright position, getting him some ice chips, resetting the machines for the day checks before turning to Jim with more serious eyes,

“This isn’t going to be easy, Jimbo. The team has serious doubts about discharging you now, especially since your improvement has just begun, but after a plea to Starfleet, I have managed to keep my promise and take you home-” holding up a hand as Jim’s smile widened,

“but it is not without conditions. You will be transported by medical craft, of course, and will be staying on a probationary basis. Dr. Ali will be accompanying us and if he judges that you are deteriorating, even a little bit, I cannot do anything to stop you from being readmitted here. You will also be continuing your medication regimen, PT, injection therapies, TPN, all the normal stuff. We have a biobed already waiting at Momma’s so it won’t be too different to your life now.”

Jim had closed his eyes again, a hit of disappointment evident, pain rising despite the fuzzy edges of sleep still remaining.

“It's not going to be a quick recovery, Jim - we knew that” McCoy went on,

“but I promise it will be better at home. You’ll be wrapped up in Momma’s quilts and affection in no time, and I won't have to leave you every night. I will be by your side, no matter what's to come.”

McCoy gently squeezed Jim’s shoulder, encouraging him to look back up. He didn’t. The pain was as evident on the monitors as it was on his face - fear too. The unspoken question,  _ if I show pain, will I be stuck here? _

“Jim… It's ok. Don’t worry, you  _ are  _ going home today. We are going to do your pain management regimen now, and you’ll get a light sedative before we leave to let you sleep in the transport. We are going to make this as painless as possible and we  _ are _ going to get you home.”

Jim’s face didn’t relax, his pain was too much. It was always hard to see him like this, but it wasn’t surprising, even on a day saturated with hope. 

This pain wasn’t something that could easily fade away, not yet, not so soon. Jim’s body was still fighting for the life of every living cell as both the drugs and his own immune system fought hard against him. He was ill, better, but ill, going home, but not without significant risk.

McCoy sighed, this day would not be fun.

“Ok, Jim. Let's do something about this pain, the formula will go down easier and once we’ve cleaned you up we should be ready to go.”

Jim was starting to lose Bones’ words now. The remnants of sleep were being replaced by the familiar darkening edges around his consciousness, surrounding him in a blanket of smothering, suffocating pain. 

This was also what morning meant: Bones had to administer the real strong stuff in the morning, a blessing and a torture. It was two spinal infusions, antihistamines and anti-nausea drugs through his central line, and usually something for his aching bones and muscles. It wasn’t nice, but it made the day tolerable, because the pain couldn’t last if Jim wanted to remain conscious.

He managed to rouse himself slightly once other voices began to fill the room. He didn’t open his eyes, he couldn’t bear more nausea without throwing up the tablespoon of formula in his stomach. But without sight, he could still easily identify the voices.

There was Dr. Ali at the foot of his bed, quietly talking to Bones who was, presumably, preparing the morning meds, and Nurse Nightly by his head. The head ICU nurse had taken a shine to Jim immediately and always helped them when it was time for Jim’s more unpleasant procedures. She was always there to hold him, to touch him gently when Bones simply couldn’t. She was the only nurse he would tolerate, she was almost like Mrs. M, but no one could really live up to Mrs. M. Soon, nobody would have to.

“Hey Sugar, almost ready?”

Her voice was bright, and the hand on his face was refreshingly cool. 

Jim could only mumble an affirmative, but internally he was aching for them to leave him alone and simultaneously begging them silently to make the pain end.

“Ok, kid, it's time to get started. Today we will be changing the spinal catheter. I know it's not the most fun but it shouldn’t take too long.” 

McCoy was back, and all business.

“Kristen, can you help me move him?”

This was the part that Jim really hated.

People were all over him. First it was the tugs on his central line, the few remaining contact monitors, and his feeding tube as they were gathered and moved away, and then hands on him, gloved hands now, as his body was slowly repositioned onto his side. 

Moving him was more than slightly uncomfortable. 

Months flat on his back had resulted in muscular degeneration despite the muscle stim therapies. The radiation had damaged his bones and lack of nutrition hadn’t helped in the healing. Whenever he tried to move, whether by his own power or someone else’s hand, his neck and back ached terribly from the strain, his hips and legs had the cold pain of weakened bones, and the ever present pounding in his head would increase from effort.

The fact that the existing night pain medication was nearly completely dissipated from his system did nothing for his tolerance to the movement.

A groan was forced out of Jim as he finally came to rest on his side. He flinched at his unintended sound of pain, as did McCoy, though Jim couldn’t see.

“Ok sweetheart, I am going to be right in front of you to help you stay stable on your side. You can hold my hand if you want to and it will be over before you know it.”

It was the same exact routine every morning. The same pain, the same humiliation, having his bare back exposed, and not even being able to turn by himself. But Nurse Nightly was comforting and her daily offer of both physical and mental support was sheepishly welcomed every time. 

“We’re gonna begin now, Jim,” Bones said from behind him.

Eyes still closed, Jim unconsciously squeezed Nightly’s hand harder.

“I’ll tell you everything that Ali and I are going to do before we do it but I know we’ve done this a million times so you can just relax and let it happen.” Bones put a hand gently on his bare back, letting him adjust to the sensation of being touched before they began in earnest.

_ Hah. Relax. That’s a good one. _

The infusions hadn’t even begun and Jim was already beginning to feel the strain of his position, his stomach muscles, whatever where left, fighting to keep him still.

Seeing this, Nightly gently placed more pillows in front of Jim to both support and comfort him. He was thankful, but all he could manage was a sigh of relief, eyes still closed and body still tense. 

Pain relief through a spinal catheter was supposed to be a better, more efficient, way to deliver pain medication to a chronic patient. The spinal catheters still needed to be changed every few days but they proved themselves worth the invasiveness due to their ability to deliver targeted pain relief with the fewest number of needles and doses through the day. The possible addition of a patient controlled pain pump had been quickly abandoned since Jim refused to use them and always ended up unconscious as a result, time-delayed, morning doses favored as the alternative. They never seemed to get their first choice of treatment with Jim.

“We are taking out your old cath now.” McCoy’s gloved hand reassuringly rubbed Jim’s shoulder, encouraging him to release his tense muscles.

Without any more delay McCoy pulled back the biofilm over Jim’s previous catheter site, wiped the skin with alcohol, and removed it all with one clean motion. It only caused a slight squirm from Jim; unfortunately, that was the easy part. The insertion would be much more painful.

“Next, we are cleaning your back.” McCoy narrated calmly.

The cold iodine solution made Jim hiss but it felt silly, seeing as the worst was yet to come.

“The numbing cream now.” This time it was Dr. Ali, speaking more to Bones than to Jim.

After a minute of waiting for the cream to work, Bones’ hand was back, touching Jim’s skin, feeling for the right spot between his vertebrae, making his tender back ache even more, then spreading the skin taught with one hand.

“Ready for the big poke, Jimbo?” 

Like he had any choice. It was better to get it over with than ask for an extra moment to breathe. Gulping for air, Jim gave a tiny nod.

Nurse Nightly squeezed his hand gently as Bones began to count,

“Three, two, one -”

At least Bones was quick about it. The needle went in before Jim had a chance to think.

Unfortunately, the needle insertion was only a first step itself. The catheter was tugged and moved about as it was secured with biofilm and prepped for the medications. 

Before Jim could get over the initial pain, the slow and torturous part had already begun. They would have to wait several minutes while Ali slowly depressed the first syringe of pain medication, allowing the medication to be properly absorbed.

As the medication entered his back and blood stream it burned bad enough to cause half-suppressed, strangled sobs every time. Thank God Jim was facing away from McCoy so he didn’t see him cringe- every time.

“You’re doing great, Jim.” Bones said.

“One more medication through your spinal cath and we’re done. You’re gonna get some strong anti-nausea meds through your line in a bit too but those should be a lot easier.” McCoy promised.

The burning was still too intense to allow Jim to speak but Bones didn’t expect him to.

“First one’s done.” Ali said.

“Ok kiddo, just one more.” McCoy rubbed Jim’s still burning back.

_ Ouch. _

“Give it a couple minutes and you’ll be feeling much better.”

The burn increased, McCoy could see it in the thin muscles on Jim’s back, in his whimpers, and in the nurse’s face. McCoy could feel the pain as if it was his own. Like every procedure, McCoy had to remind himself that this was for Jim’s own good, that he had to be strong and push on despite Jim’s cries. The only way out of the pain was through.

After another few agonizing minutes Jim was on his back again, enjoying the most pain free moments he would get for the whole day.

He was vaguely aware of movement around him, though in his morning medicated state, he barely dared to find out what they were doing, that is, until they started touching him  _ again _ .

Bones seemed to be changing his clothes, unwrapping the compression cuffs on his legs, removing his socks, pushing aside the sheets covering his body. Jim couldn’t help much but at least he wasn’t fighting until other hands were upon him, gently cleaning his chest with a warm towel.

Abandoning his drugged up peace, Jim shook his head and attempted to swat the hands away. He didn’t want this. It was humiliating and he just wanted to enjoy being pain free - alone. Was that so hard?

“No…” It came out even more pathetic than he anticipated.

“Hey Jim,” Bones grabbed his wrist gently, and lowered himself into Jim’s line of site,

“we are almost done here but we need to change your clothes, clean you up, change your urine bag, and change the dressing on your central line, then we can get you packed up to go home!”

His voice was eager but Jim’s heart sank at his words. 

A central line change was even worse than a clothes change. He would  _ never _ get used to a gaggle of people looking at his exposed body, let alone messing with all the damn lines coming out of his crotch! 

Jim shook his head even more resolutely before looking up and Bones,

“Nobody else? Only you. Please?”

It was like this every time he needed something more delicate changed. Not that he wanted Bones to see his dick, but it was better than Ali, or godforbid, strange hospital staff. 

“Sure thing, Jimbo.” McCoy waved the rest of the team out, all of them familiar with the usual routine.

“Ali, if you could please ensure that we are still on track with the transport and gather the necessary supplies? I want the prep to be as quick as possible since it will already be a long day.”

Ali nodded and exited with the rest of the staff.

“Ok Jim, let's get this over with.”

Jim nodded silently, body relaxed and eyes closed. It needed to happen, there was no use fighting anymore.resec

With the speed gained by repetition, McCoy gently disconnected Jim’s central line from its pump, sanitized, and capped it, allowing him to remove Jim’s pants without the extra lines getting tangled. Jim wore no underwear, it would only interfere with the medical equipment. In addition to the central line in his femoral artery, a clear tube had been inserted into his penis, allowing him to empty his bladder effortlessly with as much privacy possible, McCoy draped a sheet over Jim’s genitals and upper body, though it hardly seemed to matter to Jim, who was clearly pretending to be somewhere else.

With a warm, wet cloth, McCoy wiped down Jim’s legs, avoiding the line site for now. McCoy swiftly moved on to the less pleasant task of changing the line dressing. He gathered the needed materials and meticulously set up his sterile field. The sheet was moved up slightly to allow access, making Jim’s leg hairs stand up on end. McCoy peeled back the biofilm, disapprovingly examining the blotchy redness that it always caused, despite their best efforts. The tubing at the insertion site was uncoiled and the area was wiped with alcohol. Antibiotic and anti-inflammation cream was applied before the line was once again coiled, to prevent being accidentally pulled out, and securely covered with more biofilm.

McCoy disposed of all the sterile materials he had used for the delicate dressing change, giving Jim a moment to collect himself before the urinary catheter and the rest of his genitals were cleaned.

There was no need for talk, this had been their lives for so long. McCoy knew well that overall Jim preferred not to have McCoy narrate Jim’s sponge baths, it only added to the embarrassment. Instead, he simply went about his work, allowing Jim’s mind to detach for reality even while his body was subjected to less than pleasant things. Over a piece of gauze, McCoy clamped off the urinary catheter line and detached the bag secured to the biobed. After disposing of it and attaching a new one, McCoy went on to remove the biofilm securing the line to Jim’s leg. Jim made a slightly pinched expression in response to the biofilms tug on his thigh hair- his only acknowledgement of McCoy’s touches.

With clinical detachment, McCoy cleaned Jim’s inner thighs, penis, and surrounding areas, applied cream where necessary, and re-secured the catheter line with biofilm. It only took a matter of moments and was easily the least painful part, but it was the part that sent Jim farthest away. Finally, McCoy put Jim back in fresh scrub pants and coaxed him into a clean shirt. 

Mentally, Jim was long gone. He couldn’t be there now, he couldn’t be given a sponge bath, seen and washed and changed like a small child. Not by his CMO, not by his friend. 

It wasn’t hard to let it all unravel once the thoughts were entertained. The feeling of being trapped in his broken body, the feelings of fear and helplessness, the detachment from the world around him, purposeful or not, all the things that had been lost. The weight was immense, the thoughts almost too painful to sustain, but Jim was getting stronger by the day. He did not cry this time, did not outwardly panic, just lay there, eyes closed, feeling so much. But no matter how painful, no matter how deep he was diving into the mental wounds of that fateful day, being able to feel- felt… good. The drugs had left him in a weepy, uncontrolled state, erratic and senseless, but these feelings were real. They were his own. 

“Jim?” McCoy was almost reluctant to call Jim back to reality.

Jim’s eyes snapped opened, less drugged and glassy than before. McCoy couldn’t, didn’t want, to guess at Jim’s thoughts, he could give Jim that small privacy. 

“All done!” He was hopeful, but as always, he knew Jim wanted space after procedures. McCoy offered him a fresh blanket and a gentle squeeze on the arm. 

Jim smiled vaguely and slowly pulled the blanket up over himself, trying to reclaim his body best he could. He was still far, far away.

“I’ll give you some peace now, Jim. I am going to finish giving report and packing up your stuff. Give me about an hour and we should be ready to transfer you.”

McCoy left Jim to himself then, dimming the lights and shutting the door behind him. 

Jim let himself take a steadying breath. Sometimes, in the midst of all the loneliness, it felt good to be left alone. 

Sometimes mornings meant peace and reprieve. 

The uncertainty of the future, of his life outside the hospital room, chipped at the edges of his solitary peace, but it wasn’t entirely unpleasant. There was a bit of hope now. The promise of a home to go to, right there at his fingertips.

Time passed Jim with relative ease. His pain was manageable for the moment, his thoughts turned inward but not so much towards despair, he had a future now - his purgatory was over. 

In seemingly no time Bones was back, along with the many doctors and nurses who had assisted them over the weeks.

“It’s time to go!” Bones announced.

* * *

The air in the room had changed, everything was somehow lighter than before. 

This time, when people gathered around him they weren’t stone-faced and clinical, they were smiling and wishing him well, and now that he was leaving he could look at them without wanting to flee. 

Jim hadn’t been sure he would ever leave the hospital room again, not alive that is. He had been afraid and in pain in this room, but Jim hoped that he could leave the damned place with memories of the good things morning had meant there: sun, relief from pain, Bones, and a welcome reprieve from the lonely darkness. The very same things he hoped to find in the home Bones promised him.

**Notes for the Chapter:**

> While I did not use a beta reader this time, I do want to give a shoutout to those who have helped me in the past. Your input and our conversations were incredibly invaluable. For this chapter I simply did not have the time to go through detailed editing if I wanted to publish it this month. We die like men!
> 
> Live long and prosper!


End file.
